Top 4282 Data mining Jobs

Payment Integrity Analyst - Data Mining
Lyric —Remote
- $24.20 - $36.30 an hour
- Full-time
- Remote
- HIPAA
- Mid-level
- SQL
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
Federal Tax Manager - Global Compliance and Reporting - SAN JOSE / San Francisco
EY —San Jose, CA
- $103,600 - $215,800 a year
- CPA
- 5 years
- Analysis skills
- Paid holidays
- Health insurance
Routing Specialist
Aquarius, Ltd. —St. Louis, MO
- $23 - $26 an hour
- Full-time
- Oracle
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Senior Manufacturing Production Planner
Deringer Ney —Bloomfield, CT
- Full-time
- ERP systems
- Office
- Analysis skills
Quick Apply
RN Special Procedures IR and Diag Imaging
HCA Florida North Florida Hospital —Gainesville, FL
- Full-time
- Mid-level
- Critical & Intensive Care
- Neurology
- Employee stock purchase plan
- Disability insurance
Quick Apply
On-Site Operations Assistant / Mining Operations Engineer
LN ENERGY —Atlanta, GA
- $60,000 - $80,000 a year
- Full-time
- Computer Science
- English
- Mid-level
Quick Apply
Validation Engineer
Denken Solutions, Inc. —Foster City, MI
- $80 an hour
- Hybrid work
- Engineering
- Office
- 3 years
Quick Apply
Chinese Operational Language Analyst
SOSi —Annapolis Junction, MD
- $73,743 - $153,159 a year
- Weekends as needed
- Research
- Mid-level
- Office
Quick Apply
Federal Tax Manager - Global Compliance and Reporting - SAN JOSE / San Francisco
EY —San Jose, CA
- $103,600 - $215,800 a year
- CPA
- 5 years
- Analysis skills
- Paid holidays
- Health insurance
Digital Marketing Analyst
MidwayUSA —Columbia, MO
- $63,000 - $89,000 a year
- Full-time
- Marketing
- Mid-level
- Office
- Profit sharing
- Paid parental leave
Quick Apply
10d
Federal Tax Manager - Global Compliance and Reporting - SAN JOSE / San Francisco
EY —San Jose, CA
- $103,600 - $215,800 a year
- CPA
- 5 years
- Analysis skills
- Paid holidays
- Health insurance
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
UNITED REFINING COMPANY —Warren, PA
- Weekends as needed
- Oracle
- Mid-level
- Office
- Flexible spending account
- Tuition reimbursement
Quick Apply
HVAC Sales and Service Technician
CognITek Group —Lancaster, PA
- From $40,000 a year
- Full-time
- Microsoft Outlook
- Sales
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Assistant Professor of Business Analytics and Information Systems
Northern State University —Aberdeen, SD
- Full-time
- Classroom
- Computer Science
- System design
13h
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
Russian Operational Language Analyst
SOSi —Annapolis Junction, MD
- $73,743 - $153,159 a year
- Weekends as needed
- Research
- Mid-level
- Office
Quick Apply
Appointment Coordinator KAC-C
KONA AUTO CENTER INC —Kailua-Kona, HI
- $19 - $22 an hour
- Full-time
- Dealership
- English
- Driver's License
Quick Apply
Operations and Maintenance Engineer
LN ENERGY —New York, NY
- $60,000 - $80,000 a year
- Full-time
- Computer Science
- Mid-level
- SQL
Quick Apply

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 & IT Manager

Federal Tax Manager - Global Compliance and Reporting - SAN JOSE / San Francisco

Routing Specialist

Senior Manufacturing Production Planner

RN Special Procedures IR and Diag Imaging

On-Site Operations Assistant / Mining Operations Engineer

Validation Engineer

Chinese Operational Language Analyst

Federal Tax Manager - Global Compliance and Reporting - SAN JOSE / San Francisco

Digital Marketing Analyst

Federal Tax Manager - Global Compliance and Reporting - SAN JOSE / San Francisco

ERP/Software Support

Buyer

HVAC Sales and Service Technician

Assistant Professor of Business Analytics and Information Systems

Sr. Maintenance Engineer

Russian Operational Language Analyst

Appointment Coordinator KAC-C

Operations and Maintenance Engineer

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