Manager of Payment Integrity

Major Responsibilities

• Program Leadership and Staff Supervision
• Claims Audit and Payment Validation Activities
• Large Claim, Risk Adjustment, and Reinsurance Support
• Payment Integrity Program Oversight, Appeals, and Provider Collaboration
• Fraud, Waste, and Abuse (FWA) Collaboration

Knowledge and Skills

• Experience: Three to five years of similar or related experience
• Education: Equivalent to a two-year college degree or completion of a specialized course of study or certification at a business or trade school
• License: Valid RN license
• Skills: Medical coding experience preferred