Payment Integrity Program Manager

Job Summary

A company is looking for a Payment Integrity Program Development Manager responsible for improving claim payment accuracy and reducing medical spend.

Key Responsibilities

• Leverage expertise and data to identify medical cost savings opportunities
• Collaborate with internal teams to analyze claims payment inaccuracies and their impact
• Analyze medical cost trends and develop new payment integrity programs

Required Qualifications

• Bachelor's degree and a minimum of 4 years of relevant experience
• Experience working in U.S. healthcare
• Proficiency in analytical and data mining tools
• Knowledge of claims adjudication and revenue cycle management
• Experience with payment integrity concept ideation