Top 4125 "data mining" Jobs

Payment Integrity Analyst - Data Mining
Lyric —Remote
- $24.20 - $36.30 an hour
- Full-time
- Remote
- HIPAA
- Mid-level
- SQL
Data Analytics
A P Ventures LLC —Remote
- Remote
- Computer Science
- Mid-level
- Master's degree
Quick Apply
DMG Data Mining Analyst II
Machinify —Remote
- $90,000 - $140,000 a year
- Remote
- 5 years
- Mid-level
- SQL
- Health savings account
- Health insurance
Quick Apply
Data Scientist
NextKinLife LLC —Remote
- $87,000.00 - $126,386.77 a year
- Full-time
- Remote
- Mid-level
- Java
- AWS
- Dental insurance
- Parental leave
Quick Apply
Data Mining Scientist
Wilfred Knight —Remote
- Computer science
- Computer Science
- Mid-level
Data Engineer
MHC —Leawood, KS
- Full-time
- Mid-level
- Office
- Bachelor's degree
- Profit sharing
- Disability insurance
Quick Apply
Data Analyst (Remote)
Elder Research —Remote
- Full-time
- Mid-level
- Analysis skills
- Travel
- Paid time off
- Opportunities for advancement
Quick Apply
Data & IT Manager
Albany Damien Center —Albany, NY
- $70,000 - $75,000 a year
- Email
- Background check
- Computer Science
- Mid-level
- Health savings account
- Health insurance
Quick Apply
13d
Sr. Maintenance Engineer
Grand River Aseptic Manufacturing, Inc. —Grand Rapids, MI
- Day shift
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Paid holidays
- Dental insurance
Quick Apply
Routing Specialist
Aquarius, Ltd. —St. Louis, MO
- $23 - $26 an hour
- Full-time
- Oracle
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Senior Workday HRIS Analyst
Stoneridge —Novi, MI
- Full-time
- Hybrid work
- Background check
- 5 years
- Pass drug screening
ERP/Software Support
Tri Star Metals, LLC —Freeport, IL
- $75,000 - $85,000 a year
- Full-time
- Background check
- Azure
- Bachelor of Science
- Health savings account
- Health insurance
Quick Apply
Buyer
Infiltrator Water Technologies —Winchester, KY
- Full-time
- Physical & Rehabilitation Medicine
- Research
- Contracts
- Paid parental leave
- Health savings account
AVP, Credit Model Development
Synchrony —Chicago, IL
- $100,000 - $170,000 a year
- 18 years or older
- Pass drug screening
- Mid-level
- Work from home
Applied Scientist, Prime Video - Title Lifecycle Presentation
Amazon.com Services LLC —Seattle, WA
- $142,800 - $193,200 a year
- Full-time
- Mid-level
- 4 years
- AD&D insurance
- Health insurance
Financial Analyst II - Manufacturing
Rheem Manufacturing —Roswell, GA
- Full-time
- Hybrid work
- Microsoft Excel
- Oracle
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Internal Auditor
Chelan County Public Utility District —Wenatchee, WA
- $80,880 - $128,500 a year
- Full-time
- Microsoft Word
- Microsoft Excel
- Microsoft Access
- Disability insurance
- Relocation assistance
System Safety & Reliability Engineer Specialist
Rolls-Royce —Indianapolis, IN
- $122,741 - $199,454 a year
- Full-time
- 3 years
- Master's degree
- Math
- Paid parental leave
- Health savings account
VP Sales Management - Retail
Cotiviti —Remote
- $170,000 - $200,000 a year
- Full-time
- 7 years
- Research
- Analysis skills
- Paid holidays
- Disability insurance
Manager - Corporate Tax
Penske Truck Leasing —Reading, PA
- CPA
- 5 years
- Pass drug screening
3d

I want to receive the latest job alert for "data mining"

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Payment Integrity Analyst - Data Mining

Lyric -
Remote

Apply Now

Job Details

Full-time
$24.20 - $36.30 an hour

Qualifications

Policy verification in claims processing
Data-driven problem-solving
Healthcare claims compliance audits
Medical terminology

Full Job Description

Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI.

Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position.

JOB SUMMARY

The Payment Integrity Analyst (Data Mining) supports the Data Mining (DM) program by investigating payment errors due to incorrect processing of payment policies, contract terms, billing and/or coding errors to prevent and recover improper claim payments. This role performs hands-on casework in a high-volume environment including outreach, documentation, and system updates, while applying analytical skills to interpret claims and eligibility data, identify trends, and recommends process improvements that improve accuracy for the data mining program.

ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES

Investigation and verification

Review, prioritize, and independently work assigned DM leads (automated and manual), including moderate-to-complex and high-dollar cases, to determine verification steps and next actions.
Investigate and validate payment terms (Inpatient, Outpatient, Professional, Ancillary) using internal systems, payer portals, contracts, and other approved data sources.
Apply payment policies, contract terms and coding guidelines, including CMS and AMA guidance as applicable, to determine the correct reimbursement and document the rationale for the payment determination.
Reconcile discrepancies across sources (contract data and paper forms, conflicting policy and contract terns) and drive cases to a clear, audit-ready determination; escalate edge cases per policy.

Collaboration, documentation, and system updates

Analyze claim inventory from identification to resolution. Assist in developing concept overviews and analysis. Collaborate with team to configure client specific business rules.
Assist in compiling sample claims and supporting documentation for Client review and approval. Maintain a library that includes instructions for validating specific audit concepts.
Create clear, detailed, and accurate case notes that capture verification steps, evidence, and outcomes in internal tools to support audits and downstream recovery/reprocessing.

Payment integrity support & Operational excellence

Provide validated DM outcomes that support downstream payment integrity activities (recovery, reprocessing, adjustments) with minimal rework.
Prepare and evaluate documentation needed for inquiries, disputes, and appeals related to determinations, as assigned.
Meet or exceed established productivity, turnaround time, and quality/audit standards while managing a high-volume case queue.

Analytical contribution

Track outcomes and error categories, identify root causes of recurring DM issues and false positives, and recommend opportunities to streamline research, improve data quality, and reduce incorrect payments.
Use Excel and other tools to support ad hoc analysis (e.g., trend review, inventory quality checks, and performance insights); partner with stakeholders to clarify requirements and improve workflows.
Reconcile discrepancies across sources (eligibility feeds, member/group data, claim history, and third-party responses) and drive cases to a clear, audit-ready determination.

REQUIRED QUALIFICATIONS

Minimum of one (1) year of combined experience in healthcare, such as prior work in health insurance, claims processing or adjudication, or fraud, waste and abuse detection.
Minimum of one (1) year experience auditing medical claims to identify improper payments as a Payment Integrity Vendor or within a Health Plan’s Payment Integrity team.
Minimum of one (1) year of experience performing data analytics with large data sets
Minimum of one (1) year of experience in medical billing codes including but not limited to CPT, ICD-10-PCS, ICD-10-CM, HCPCS, and NDC, as well as an understanding of medical terminology, and prospective payment systems including DRG, OPPS, and MIPS

PREFERRED QUALIFICATIONS

Bachelors degree in business or healthcare/related field
Experience in various claim payment methodologies for professional, facility, and ancillary providers or working knowledge of payment integrity auditing concepts.
Experience with SQL.
Experience within high-volume, SLA-driven operations teams.
Creative thinker with an entrepreneurial spirit.
Strong written and verbal communication skills.
Excellent documentation accuracy and attention to detail.
Ability to work within established productivity and quality metrics.
Comfortable navigating multiple systems, portals, and payer interfaces.
Strong problem-solving skills with the ability to reconcile conflicting or incomplete information.
Ability to maintain confidentiality and comply with HIPAA and data security standards.

***The US base salary range for this full-time position is:

$24.20 - $36.30

The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation. ***

Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success.

Apply Now

Refine Your Search

"data mining" jobs

Payment Integrity Analyst - Data Mining

Data Analytics

DMG Data Mining Analyst II

Data Scientist

Data Mining Scientist

Data Engineer

Data Analyst (Remote)

Data & IT Manager

Sr. Maintenance Engineer

Routing Specialist

Senior Workday HRIS Analyst

ERP/Software Support

Buyer

AVP, Credit Model Development

Applied Scientist, Prime Video - Title Lifecycle Presentation

Financial Analyst II - Manufacturing

Internal Auditor

System Safety & Reliability Engineer Specialist

VP Sales Management - Retail

Manager - Corporate Tax

I want to receive the latest job alert for "data mining"

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected