Texas Licensed Payment Integrity Supervisor

Job Summary

A company is looking for a Payment Integrity Supervisor to oversee the daily activities of the payment integrity team.

Key Responsibilities

• Supervise daily activities related to quality assurance and provider appeals
• Assist the team with problem-solving and payer policy questions regarding audits
• Ensure timely resolution of appeals and grievances while managing multiple projects

Required Qualifications, Training, and Education

• Associate Degree in Nursing or higher required; BSN preferred
• Current licensure as a Registered Nurse in the state of employment
• 5+ years of experience in acute clinical areas; 2+ years of supervisory experience preferred
• Demonstrated knowledge of CMS guidelines and ICD-10 coding
• 2+ years of medical claims auditing experience preferred