Payment Integrity Subject Matter Expert - Inpatient/Outpatient

About this role

We are seeking experienced Inpatient and Outpatient Payment Integrity Subject Matter Experts (SMEs) to support the identification of overpayment opportunities, development of new audit concepts, enhancement of existing concepts, and improvement of payment integrity analytics. This role requires deep knowledge of healthcare claims, coding, reimbursement, audit outcomes, and billing patterns across inpatient and outpatient settings.
The SME will collaborate closely with analytics, clinical, coding, operations, and technology teams to translate healthcare billing expertise and claim-level insights into scalable, high-performing audit concepts, business rules, and automated selection strategies.
This is a part-time, temporary position requiring up to 20 hours per week. Work hours may vary based on project needs, audit concept development priorities, and collaboration requirements with analytics and operational teams. Project is expected to last 4-6 months.
*Base Pay Range: $75.00 - $100.00/hr
For more information on benefits and what we offer please visit us at
Originally posted on Himalayas