virtual vocationsNew York, NY
Manager of Payment Integrity
Manager of Payment Integrity
Manager of Payment Integrity
virtual vocationsNew York, NY
3 days ago
Compliance ManagersMedical and Health Services ManagersClaims Adjusters, Examiners, and Investigators
Financial Transactions Processing, Reserve, and Clearinghouse ActivitiesPharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsOther Activities Related to Credit Intermediation
Apply for this role (opens in a new tab)To manage strategic fraud, waste, and abuse activities, the full-time Manager of Payment Integrity will develop and implement compliance measures, lead investigative teams, and create educational materials while working remotely.
Key responsibilities:
Monitor business processes to ensure integrity and compliance in billing and claims payment
Lead teams of analysts to investigate fraud, waste, and abuse referrals effectively
Prepare and present the fraud, waste, and abuse program to state and federal personnel as requiredRequired qualificationsBachelor's degree in Business, Healthcare, Criminal Justice, or a related field, or equivalent experience
4+ years of experience in medical claim investigation, compliance, or fraud and abuse
Thorough knowledge of medical terminology
Previous experience in a managed care environment preferred
Medical records or coding license preferred
Also on the board Same function, level within a rung
Level
Manager
Location
New York, NY
Occupation
Compliance Managers
Industry
Financial Transactions Processing, Reserve, and Clearinghouse Activities
Posted
3 days ago