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Manager of Payment Integrity

L5

virtual vocationsDenver, CO4 days ago

Occupations

Compliance ManagersMedical and Health Services ManagersFinancial Managers

Industries

Financial Transactions Processing, Reserve, and Clearinghouse ActivitiesOther Activities Related to Credit IntermediationPayroll Services
To manage strategic fraud, waste, and abuse activities, the full-time Manager of Payment Integrity will develop and implement compliance measures, lead investigative teams, and create educational materials while working remotely.
Key responsibilities: Monitor business processes to ensure integrity and compliance in billing and claims payment Lead teams of analysts to investigate fraud, waste, and abuse referrals effectively Prepare and present the fraud, waste, and abuse program to state and federal personnel as required
Required qualifications: Bachelor's degree in Business, Healthcare, Criminal Justice, or a related field, or equivalent experience 4+ years of experience in medical claim investigation, compliance, or fraud and abuse Thorough knowledge of medical terminology Previous experience in a managed care environment preferred Medical records or coding license preferred
Apply now (opens in a new tab)
Apply now (opens in a new tab)

Level

SeniorL5

Location

Denver, CO

Occupation

Compliance Managers

Industry

Financial Transactions Processing, Reserve, and Clearinghouse Activities

Posted

4 days ago

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