Manager, Payment Integrity

Overview

Required skills & experience ● 5+ years of relevant and recent experience & work with healthcare payers in the payment integrity space including claims processing, auditing and adjudication. ● Genetic counseling claims experience is a must. ● Bachelor’s Degree in relevant field required ● Experience with payers in payment integrity. Someone who understands the billing/coding/back end of payment integrity pieces of the payer world. ● Extensive knowledge of reimbursement methodologies and acceptable billing practices ● Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards ● Current certified coder (CCS, CCS-P or CPC) preferred, or registered health information technician (RHIA/RHIT), or RN, LPN with coding knowledge required ● Experience managing internal and external relationships What You Need to Know: ● Bachelor’s Degree required ● 100% remote ● The Manager, Payment Integrity (PI) is responsible for leading the operations and delivery of the payment integrity product line. ● Time is focused on new product development, existing product maintenance, team management and client/ vendor implementations in line with defined strategic priorities. ● Primary duties include operational planning and oversight, as well as resource, relationship, and people management. ● Provide insight to VP, Payment Integrity annually during budget setting process ● Work within approved budget and make adjustments as necessary to meet financial goals

Benefits

Company

The authority on the appropriate use of genetic tests. The largest and most experienced nationwide full-time staff of independent genetics specialists.