Job Overview
Location
Remote - US
Job Type
Full-time
Category
Data & Analytics
Date Posted
April 22, 2026
Full Job Description
📋 Description
- • The Payment Integrity Analyst (Data Mining) plays a critical role in preventing improper healthcare payments by investigating and validating claim discrepancies using payment policies, contract terms, and coding guidelines to ensure accurate reimbursement and reduce waste in the healthcare system.
- • Day to day, the analyst reviews and prioritizes data mining leads, investigates payment errors across inpatient, outpatient, professional, and ancillary claims, applies CMS and AMA guidelines, reconciles conflicting data sources, documents audit-ready case notes, and supports recovery and reprocessing efforts while meeting productivity and quality standards.
- • Lyric is an AI-first healthcare technology company with 35 years of pre-pay editing expertise, recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity, HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience, dedicated to simplifying the business of care through innovation and integrity.
- • In this role, the analyst will deepen expertise in healthcare payment integrity, medical coding (CPT, ICD-10, HCPCS), data analysis using Excel and SQL, and process improvement, while developing skills in audit documentation, stakeholder collaboration, and identifying root causes of payment errors to drive systemic improvements.
🎯 Requirements
- • 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
- • Experience with SQL (preferred)
- • Bachelors degree in business or healthcare/related field (preferred)
🏖️ Benefits
- • Opportunity to work with an AI-first healthcare technology company recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity
- • HI-TRUST and SOC2 certified workplace ensuring high standards of data security and compliance
- • Recipient of the 2025 CandE Award for Candidate Experience, reflecting a strong commitment to employee and applicant experience
- • Remote work flexibility within the U.S.
- • Exposure to complex healthcare payment systems and opportunities to contribute to process improvements that reduce waste and improve care affordability
Skills & Technologies
About TBC Corporation
TBC Corporation is one of North America’s largest marketers of automotive replacement tires through a multi-channel network of wholesale, retail and franchise operations. The company manufactures and distributes proprietary brands such as Milestar, Lionhart and Americus alongside national brands, serving independent tire dealers, commercial fleets and consumers through more than 3,200 company-owned and affiliated locations. Headquartered in Palm Beach Gardens, Florida, TBC operates distribution centers across the United States and provides services including tire design, testing, logistics and technical support for passenger, commercial and specialty vehicle applications.
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