State Licensed Payment Integrity Supervisor
Job Summary
Leading a team of clinical coding compliance nurses and non-clinical staff, the full-time State Licensed Payment Integrity Supervisor will manage the code editing adjudication process, ensuring compliance and quality standards while working remotely.
Key responsibilities
- Oversee the code editing adjudication process, ensuring production standards and quality audits are met
- Serve as a liaison with health plans and other departments to enhance operational efficiencies and meet key performance indicators
- Research coding questions and provide expert testimony in state fair hearings regarding provider complaints
Required qualifications
- Associate's degree in Medical Billing and Coding, Healthcare, or a related field, or equivalent experience
- 5+ years of experience in account management, nursing, healthcare management, or related fields
- Experience with code editing software systems in a managed care organization preferred
- Current state's RN license or Certified Professional Coder (CPC) preferred
Complete Job Description
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