Top 70 Payment integrity Jobs in Calhoun, Ga

Payment Integrity Analyst
Health One Alliance, LLC —Dalton, GA
- Full-time
- Microsoft Word
- Background check
- Pass drug screening
- Wellness program
- Health savings account
Medical Office Registrar - HPG Primary Care Calhoun - FT - Days
Vitruvian Health —Calhoun, GA
- Full-time
- Primary Care
- High school diploma or GED
- Typing
- Wellness program
- 403(b) matching
Online Grocery Pick-Up Clerk
Kroger —Calhoun, GA
- Part-time
- Basic math
- Adults
- Cash register
- Paid holidays
- Health insurance
HPG Primary Care Calhoun - Medical Office Registrar - PRN
Vitruvian Health —Calhoun, GA
- Part-time
- Primary Care
- High school diploma or GED
- Typing
8d
Parts Administrator
VANGUARD TRUCK CENTERS LLC —Adairsville, GA
- $19 - $22 an hour
- Background check
- Customer service
- Computer literacy
- Disability insurance
- Health insurance
Quick Apply
7d
Registrar
Vitruvian Health —Dalton, GA
- Part-time
- Hospital
- Data entry
- Radiology
CDL A Truck Driver
US Foods, Inc. —Calhoun, GA
- $24.87 - $58.00 an hour
- Full-time
- Customer service
- English
- CDL A
- Employee stock purchase plan
- Disability insurance
General Manager (Bilingual)
Community Choice Financial Family of Brands —Dalton, GA
- $19.25 an hour
- Weekends as needed
- Background check
- 18 years or older
- Spanish
- Paid training
- Health savings account
3d
Assistant Community Manager - The Ridge at Calhoun R0196806 The Ridge at Calhoun Calhoun, Georgia Full time
Greystar —Calhoun, GA
- $22 - $24 an hour
- Email
- Word processing
- Mid-level
- Office
- Paid parental leave
- Paid holidays
10d
Executive Administrator – Practice Management
Dalton Optometry —Dalton, GA
- $36,600 - $41,600 a year
- Full-time
- HIPAA
- Contracts
- Senior level
Admissions - Registrar - FT - Swing Shift
Vitruvian Health —Dalton, GA
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Hospital
- Wellness program
- 403(b) matching
Medical Office Registrar - PRN
Vitruvian Health —Dalton, GA
- Part-time
- High school diploma or GED
- Typing
- Communication skills
Manager Finance
Mohawk Industries —Calhoun, GA
- 6 years
- CPA
- Office
Business Office Manager
Vitruvian Health —Dalton, GA
- 8 hour shift
- Skilled nursing facility
- Mid-level
- Office
- Wellness program
- 403(b) matching
Delivery Merchandiser-Non CDL
Beverage South —Rome, GA
- Monday to Friday
- DOT physical examination
- Ability to lift 50 pounds
- Home daily
Financial Navigator - Patient Access @ North Fulton
2510 Cobb Hospital, Inc. —Cartersville, GA
- Full-time
- Hospital
- Mid-level
- High school diploma or GED
Medical Office Registrar - HPG Administration - PRN
Vitruvian Health —Dalton, GA
- Part-time
- High school diploma or GED
- Typing
- Communication skills
Medical Debt Collections Call Center Agent
Redmond Regional Medical Center —Rome, GA
- Full-time
- Remote
- Entry level
- Employee stock purchase plan
- Disability insurance
Quick Apply
1d
Sales Coordinator
Mohawk Industries —Dalton, GA
- Research
- Office
- Residential
Accounts Payable Specialist
KTI Logistics LLC —Rydal, GA
- From $42,000 a year
- Full-time
- Mid-level
- Office
- Analysis skills
- 401(k)
- Paid time off
Quick Apply
1d

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Payment Integrity Analyst

Health One Alliance, LLC
Dalton, GA

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Job Details

Full-time

Benefits

Wellness program
Health savings account
AD&D insurance
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Paid time off
401(k) 4% Match
Employee assistance program
Vision insurance
401(k) matching
Life insurance
Pet insurance

Qualifications

High school diploma or GED
Driving

Full Job Description

MISSION
Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.

VALUES
HealthOne is guided by a cultural framework that embodies our values and drives our decisions.

Our PURPOSE is to care for people by connecting them to resources that help protect them in health related situations. To fulfill our purpose, we align our PRIORITIES to ensure each decision we make is ethical, empathetic, economical, and efficient. We care for PEOPLE by being welcoming, authentic, truthful, consistent, and humble. We are continuously looking for ways to improve our PROCESS and how we get things done.

HealthOne seeks individuals with integrity and heart to embody our values. Whether you’re starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals.

JOB PURPOSE
A Payment Integrity Analyst reviews healthcare claims, payments, and billing to find errors, fraud, waste, or abuse, ensuring compliance with rules (like CMS) and policies, using strong data analysis, medical coding (CPT/ICD-10), and auditing skills to prevent financial loss and improve accuracy, often working with vendors and internal teams. Key duties include auditing claims, investigating anomalies, analyzing data for trends, collaborating on billing edits, and preparing reports to support cost containment for health plans.

ESSENTIAL JOB DUTIES

Review and audit healthcare claims to identify payment errors, overpayments, underpayments, fraud, waste, and abuse (FWA).
Ensure compliance with CMS regulations, state and federal guidelines, health plan policies, and provider contract terms.
Analyze medical records, itemized bills, and claim data to validate coding accuracy and medical necessity.
Apply CPT, HCPCS, ICD-10-CM/PCS, and modifier guidelines to validate correct reimbursement.
Identify trends, patterns, and anomalies through data analysis to support cost containment initiatives.
Perform detailed reviews of high-dollar and complex claims to ensure payment accuracy, contract compliance, and medical necessity prior to or after payment.
Investigate potential payment integrity issues, including duplicate payments, unbundling, upcoding, and incorrect modifiers.
Collaborate with internal teams (Claims, Configuration, Provider Relations, Compliance, Legal, Analytics, Medical Management) to resolve findings.
Work closely with internal and external vendors to review audit findings, validate recoveries, and implement corrective actions.
Prepare detailed audit documentation, summaries, and reports for leadership, compliance, and recovery tracking.
Present audit findings and recommendations to stakeholders in a clear and professional manner.
Monitor and track audit outcomes, recoveries, and key performance indicators (KPIs).
Participate in continuous process improvement initiatives to enhance payment accuracy and efficiency.
Stay current with regulatory updates, coding changes, CMS guidance, and industry best practices.
Support internal and external audits, regulatory requests, and compliance reviews as needed.
Maintains regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Works to encourage and promote Company culture throughout the organization
Other duties as may be assigned

QUALIFICATIONS

High School Diploma or GED required
Associates or Bachelor's degree preferred
A minimum of three years’ experience in claims processing required, must include Professional and Institutional processing; previous experience in medical billing and coding required if no claims processing experience
Knowledge of ICD-10, CPT4, DRG, HCPCS codes, medical terminology, EDI and HIPAA protocols preferred
Knowledge of UB and HCFA 1500 forms
Experience with Word and Excel
Experience with SQL reporting is preferred

PHYSICAL REQUIREMENTS
Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

BENEFITS
401K (4% Match, Immediate Vesting)
Accident insurance
Competitive salary
Critical Illness Insurance
Dental Insurance
Employee Assistance Program
Flexible Spending Account
Health & Wellness Program
Health Savings Account
Life & AD&D Insurance
Long Term Disability
Medical Insurance
Paid Time Off
Pet Insurance
Short Term Disability
Vision Insurance

PRE-EMPLOYMENT SCREENING
Drug Screen and Background Check Required

HEALTHONE IS AN EQUAL OPPORTUNITY EMPLOYER
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status, or any other status protected by state or federal law.

Apply Now

Refine Your Search

payment integrity jobs in calhoun, ga

Payment Integrity Analyst

Medical Office Registrar - HPG Primary Care Calhoun - FT - Days

Online Grocery Pick-Up Clerk

HPG Primary Care Calhoun - Medical Office Registrar - PRN

Parts Administrator

Registrar

CDL A Truck Driver

General Manager (Bilingual)

Assistant Community Manager - The Ridge at Calhoun R0196806 The Ridge at Calhoun Calhoun, Georgia Full time

Executive Administrator – Practice Management

Admissions - Registrar - FT - Swing Shift

Medical Office Registrar - PRN

Manager Finance

Business Office Manager

Delivery Merchandiser-Non CDL

Financial Navigator - Patient Access @ North Fulton

Medical Office Registrar - HPG Administration - PRN

Medical Debt Collections Call Center Agent

Sales Coordinator

Accounts Payable Specialist

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