Payment Integrity Analyst I

About HMA

Healthcare Management Administrators (HMA) is a leading third-party administrator of health plans serving employers across the Pacific Northwest and beyond. The company creates tailored health plan solutions for medium to large organizations and supports those offerings with strong customer service, affordable coverage options, and a people-first culture.

HMA has been recognized for three consecutive years as one of Washington's Best Workplaces by its staff and PSBJ. Its culture is guided by the mission Proving What's Possible in Healthcare™ and the values People First!, Be Extraordinary, Work Courageously, Own It, and Win Together.

The organization looks for teammates who genuinely care about others, do well in changing environments, enjoy collaborative work, take on complex problems with confidence, share ideas boldly, stay resilient, and focus on results.

Role Overview

The Payment Integrity Analyst I is responsible for the efficient, accurate, and high-quality delivery of assigned payment integrity programs. This role uses claims knowledge, program familiarity, and analytical skills to manage daily work for initiatives such as CMS Demand Case and Subrogation. The position also involves researching questions, resolving issues, spotting opportunities to improve processes, and helping strengthen the overall payment integrity portfolio.

Key Duties

• Apply analytical, troubleshooting, and quality control skills to support timely and accurate execution of payment integrity programs.
• Use healthcare knowledge, technical tools such as QicLink and Excel, and vendor reporting to review and evaluate data in detail.
• Detect issues, suggest practical fixes, and follow matters through to resolution.
• Recommend and help implement new program enhancements that improve cost containment outcomes for HMA and its clients.
• Monitor, organize, and report daily program inventory for both immediate prioritization and longer-term planning.
• Review existing processes and policies and design improvements that are durable and measurable.
• Create clear written reference materials, including procedural work instructions and job aids, to support standard practices and program updates.
• Work closely with internal partners such as Appeals, Claims, Client Success, and Stop Loss to provide a coordinated experience for clients and members.
• Communicate with payment integrity vendors and government agencies to keep programs aligned with expectations.
• Stay current on claims processing, related systems, and applicable government rules, while pursuing additional training relevant to the role.

Requirements

• High school diploma is required.
• Hands-on experience with ICD-10 and CPT coding is required.
• At least 3 to 5+ years of claims processing experience in the insurance industry.
• 2+ years of data entry experience.
• Intermediate Excel ability, including building useful spreadsheets and working with data.
• Capability to manage a complex daily queue and prioritize work effectively.
• Strong investigative skills with the ability to identify the root cause of issues.
• Ability to assess how possible actions or decisions may affect outcomes and choose the best option.

Compensation and Benefits

The base salary for this role in the greater Seattle area is $73,000 to $81,000, depending on geography, skills, experience, education, and other job- or market-related factors. Performance-based incentive bonuses are also available.

HMA notes that the salary, compensation, and benefits details were accurate at the time of posting and may be updated later in line with applicable law.

Full-time employees receive a broad rewards package that includes 17 days of paid time off for individual contributors, 12 paid holidays, two paid personal days, one paid volunteer day, company-subsidized medical, dental, vision, and prescription coverage, company-paid disability, life, and AD&D insurance, voluntary insurance options, HSA and FSA pre-tax programs, a 401(k) plan with company match, an annual $500 wellness incentive, a $600 wellness reimbursement, remote work and continuing education reimbursements, a discount program, parental leave, and up to $1,000 in annual charitable giving match.

Work Environment and Additional Details

HMA supports flexible schedules across U.S. time zones and offers the choice to work remotely or from its renovated office near Seattle, which includes free parking, a gym, and refreshments. The company also promotes career growth through its performance management program and builds team connection through events such as an all-hands meeting, summer picnic, trivia night, and holiday party.

The company hires from across the United States except Hawaii and the cities of Los Angeles and San Francisco. A background screen is required before employment begins.

Employees may encounter protected health information (PHI) during normal work duties and must use and disclose it only on a need-to-know basis in accordance with HMA policies and procedures. HMA is an equal opportunity employer.