Job Summary
A senior healthcare company is seeking a Remote Payment Integrity Claims Program Manager.
Individual must be able to fulfill the following responsibilities:
- Conduct development, implementation, and management of the Payment Integrity program
- Act as the Day-to-Day relationship owner of Payment Integrity vendors
- Perform oversight of program workflow processes, inventory and performance
Applicants must meet the following qualifications:
- 5+ years in payment Integrity with focus in 2 or more: Data Mining, DRG Validation, Clinical Audit, COB, Subrogation, FWA, or Prepay Review
- 3-4 years experience with Medicare and/or Medicaid Programs
- Bachelor’s degree in business, management, health care administration or other related field or equivalent work experience required
- Experience with data analysis techniques
- Track record of success developing and implementing systems and processes and setting and achieving ambitious targets
