Top 2900 Program project analyst Jobs in Remote

Payment Analyst, Healthcare
Signature Performance, Inc —Remote
- $110,000 - $118,000 a year
- Full-time
- Background check
- 5 years
- System design
- Paid holidays
- Disability insurance
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Accommodations Plus International —Remote
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Ascension —Remote
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Integrity Solutions Ltd —Remote
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Board Certified Behavior Analyst (BCBA)- Micro-School Setting
Neurodiversity Education Research Center —Phoenix, AZ
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Enterprise Community Partners —Columbia, MD
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Sun River Health —Remote
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Tech Talent Link —Remote
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- 2 years
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Lead Systems Analysts with GIPS and Performance and Investment data - Remote
Yoh, A Day & Zimmermann Company —Boston, MA
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Coding Quality Analyst - Inpatient
UW Health —Middleton, WI
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Data Systems Analysts, Inc. —West Union, WV
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5d

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program project analyst jobs near remote

Payment Analyst, Healthcare

Signature Performance, Inc -
Remote

Quick Apply

Job Details

Full-time
$110,000 - $118,000 a year

Benefits

Paid holidays
Disability insurance
Health insurance
401(k)
Tuition reimbursement
Paid time off
401(k) matching
Professional development assistance
Life insurance
Paid sick time

Qualifications

VLOOKUP function
National Correct Coding Initiative (NCCI) guidelines
EDI
Medicare
Medical law
Health insurance policy knowledge
CMS
Regulatory compliance in claims processing
Medical claims processing software
SQL
CMS regulatory compliance
Medicare regulations
Data-driven problem-solving
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid regulations
Medicaid
Query management
Excel data analysis

Full Job Description

About You

You are a person who loves to identify discrepancies, prevent overpayments, and ensure adherence to regulatory, contractual, and coding guidelines. We need someone who has expertise in medical coding, reimbursement methodologies, and healthcare policy and can apply that expertise to develop, implement, and maintain claims editing rules and audit processes. In the role of Payment Integrity Analyst, you will be responsible for ensuring the accuracy and compliance of healthcare claim payments across commercial, Medicare, and Medicaid lines of business.

Tell us about your experience in Payment Integrity.
Are you a team player and a self-motivator?
What is your experience with conducting business in a way that is credit to a company?
We are counting on you to manage multiple projects using your problem-solving skills.
We are looking for someone UNCOMMON. What is uncommon about you?

Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you.

About The Position

Key Responsibilities

Lead complex claim audits and investigations involving high-risk or high-value claims
Design, develop, and maintain advanced claims editing rules and logic
Translate complex regulatory and reimbursement policies into system specifications
Oversee testing, validation, and implementation of editing rules
Conduct root cause analysis and recommend systemic solutions
Monitor CMS, OIG, and regulatory updates; ensure organizational compliance
Act as SME for coding, billing, and payment integrity methodologies
Mentor junior analysts and provide technical guidance
Collaborate with IT, policy, and leadership teams on strategic initiatives
Support benefit configuration and optimization in platforms like TriZetto Facets
Present findings, insights, and recommendations to leadership

Claims Review & Audit

Perform pre-pay and post-pay reviews of medical claims for accuracy, medical necessity, and compliance
Identify billing errors including duplicate claims, unbundling, upcoding, and modifier misuse
Ensure alignment with Tricare and VA Policy, CMS, state regulations, and payer-specific policies

Payment Integrity & Recovery

Detect and quantify overpayments and support recovery efforts
Analyze claim patterns to identify systemic issues and cost-saving opportunities
Partner with recovery vendors and internal teams to resolve discrepancies

Policy & Rule Development

Interpret healthcare policies (Tricare/VA Policy, CMS manuals, NCCI edits, LCDs/NCDs, fee schedules)
Translate regulatory and coding guidance into automated claims editing logic
Define rule specifications, decision pathways, and acceptance criteria
Support configuration and optimization of claims editing platforms (e.g., Optum CES, TriZetto Facets)

Data Analysis & Validation

Analyze large datasets to identify trends, anomalies, and root causes of payment errors
Develop SQL queries and reports to support audit findings and rule validation
Perform testing and validation of editing rules and system configurations

Regulatory Monitoring & Compliance

Monitor updates from Tricare and VA Policy, CMS, OIG, and industry sources for regulatory changes
Maintain compliance with federal and state healthcare laws and reimbursement policies
Support development and maintenance of medical policies and procedures

Collaboration & Communication

Work cross-functionally with claims, IT, clinical, compliance, and Client Policy teams
Serve as a subject matter expert (SME) on coding, billing, and payment integrity issues
Communicate findings, policy interpretations, and recommendations to stakeholders

Minimum Requirements:

Associate's or Bachelor's degree in Health Administration, Public Health, Business, or related field (or equivalent experience)
5+ years of experience in healthcare claims, payment integrity, auditing, or revenue cycle
Advanced expertise in coding systems, reimbursement methodologies, and CMS regulations
Strong experience with claims editing platforms (e.g., Optum CES)
Advanced SQL and data analysis skills
Demonstrated experience in rule development and system configuration
Experience with Tricare and Veterans Administration, Medicare, Medicaid, and/or commercial reimbursement methodologies
Hands-on experience with claims adjudication and editing systems
Strong knowledge of:
- CPT, HCPCS, ICD-10 coding systems
- NCCI edits and CMS guidelines
Proficiency in:
- SQL and data analysis
- Excel (pivot tables, VLOOKUP, data manipulation)
- Experience with EDI transactions, CMS-1500, and claims workflows
One or more of the following:
- CPC (Certified Professional Coder)
- CCS / CCS-P (Certified Coding Specialist)
- RHIT / RHIA
Strategic thinking
Leadership and mentorship
Advanced analytical and technical skills
Deep regulatory and policy expertise
Strong decision-making and problem-solving ability

About Us

You are uncommon. We are, too. We are looking for people to help us in our mission of working hard at lowering healthcare administrative costs for federal government agencies, payers, and providers. At Signature, our mission is to improve the health of our clients' business and make the lives of the people we work with better. As we continue to experience exponential growth, we are looking for uncommon individuals to enhance our vision. We will continue to accomplish our mission by leading with our values of Passion, Courage, Integrity, and Respect in all interactions, making us a consistent annual Best Places to Work organization. We need uncommon leaders with uncommon qualities to shape our uncommon culture and achieve our uncommon mission.

About the Benefits

When you are a member of Signature Performance, you are a part of a solutions-based organization where the values of passion, integrity, courage, and respect are the driving forces behind all our decision-making. We trust you to do important work and bring the best version of yourself to work every day, so we want to help you achieve a work-life balance while consistently challenging yourself. Signature believes in fully developing each one of our Associates. Our performance-driven philosophy boasts competitive pay and additional position specific incentives, where world-class training and development, resources, and events drive our award-winning culture where everyone thrives.

Health Insurance
Fully Paid Life Insurance
Fully Paid Short- & Long-Term Disability
Paid Vacation
Paid Sick Leave
Paid Holidays
Professional Development and Tuition Assistance Program
401(k) Program with Employer Match

Requirements:

U.S. Citizenship or naturalized citizenship is required for this position.
All work on all positions at Signature Performance must be completed in the continental United States, Alaska, or Hawaii.

Compensation: $110,000*-$118,000/Annually
Additional Details : Monday - Friday 8:00a - 5:00p CST

Full Time

Benefits:

401(k)
401(k) matching
Health insurance
Life insurance
Paid time off
Professional development assistance

Work Location: Remote

Quick Apply

Refine Your Search

program project analyst jobs in remote

Payment Analyst, Healthcare

AI Strategy Analyst

USAF Senior Cost Analyst

HRIS Analyst

Manager of Program Integrations (Remote)

Entry Level Business Analyst

Entry Level GRC Analyst

Integration Technology Analyst

Pipeline Integrity Management Consultant

Board Certified Behavior Analyst (BCBA)- Micro-School Setting

Sr. Complex Projects Analyst (Sales)

LIHTC Transaction Structuring, Assistant Director

Data Engineer

Sr CareAdvance Configuration Analyst (strong configuration experience required)

Lead Systems Analysts with GIPS and Performance and Investment data - Remote

Senior Land Surveyor

Power Platform Developer CPE CBRND

Coding Quality Analyst - Inpatient

Power Platform Developer CPE CBRND

Power Platform Developer CPE CBRND

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