Program Integrity Appeals Manager

Job Summary

Program Integrity Appeals Manager is a full-time position responsible for managing complex healthcare appeals, collaborating with various stakeholders to drive revenue recovery and ensure compliance with billing issues, all while enjoying a flexible and fully remote work environment.

Key Responsibilities

• Manages a team by hiring, training, assigning work, and evaluating performance to meet operational goals
• Designs and implements the integrity appeals program and administers the appeals process with audit contractors
• Develops policies for tracking audit denials and manages medical necessity audits related to billing

Required Qualifications

• High School Diploma or GED
• 5-10 years of relevant experience
• 2-5 years of supervisory experience
• Preferred: Bachelor's Degree in Business, Healthcare Administration, Nursing, or related field
• Preferred: 10+ years of relevant experience