Nurse Manager, Pre-Pay Claims

Job Summary

Leading a team of clinical professional investigators, the remote Nurse Manager, Pre-Pay Claims will manage day-to-day operations, oversee auditing of medical records, and ensure timely decision-making on claims while driving process improvements and client satisfaction.

Key Responsibilities

• Provide collaborative leadership to matrix partners and ensure client-savings and internal revenue targets are met
• Manage operations client workgroups to ensure successful operational readiness and issue resolution
• Perform data analysis to identify staff performance gaps and implement development strategies

Required Qualifications

• Nurse or Certified Coder with active credentials
• 3+ years of management experience
• 3+ years of Payment Integrity FWAE Clinical Team and Process experience
• 2+ years of experience in a production-based environment
• 2+ years of experience in supporting clients with varying requirements