Senior Director Payment Integrity Edits

Location: Remote
Compensation: To Be Discussed
Staff Reviewed: Tue, Feb 06, 2024
This job expires in: 11 days

Job Summary

A company is hiring a Senior Director, Payment Integrity (Edits) to join their Payment Integrity team.

Responsibilities:
  • Set, drive and execute on the pre-payment payment integrity strategy and vision to enhance the program's overall value, including determining and uncovering new opportunities
  • Collaborate with Operations, Technology, and Network team leadership to identify and implement pre-payment editing performance strategies
  • Manage payment integrity vendor relationships to build best in class program for editing and FWA

Qualifications:
  • A bachelor's degree or commensurate 4 years of experience
  • 15+ years experience in a cross-functional operations environment
  • 3+ years of experience working at a health plan/payer
  • Extensive knowledge of claims operations and processing, insurance products, contracts, and regulatory and policy language
  • Experience analyzing and improving processes and workflows

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