Senior Payment Integrity Professional - WAH in US

Profile

Description

Responsibilities

This is a work at home position, Mon-Fri, 8am-5pm, with possible travel up 25%.

The Senior Payment Integrity Professional contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications


Proven ability applying legal knowledge to job functions, to include reading contracts and translating language into layman's terms
Minimum of 3 years work experience interpreting Medicare and/or Medicaid claims
Proven ability building relationships with cross-functional teams
Strong attention to detail, organizational skills and meeting facilitation skills
Ability to maintain efficient records and documentation
Ability to work in a fast-paced environment with a focus on meeting quick due dates
Strong verbal and written communication skills
Experience leading people, projects and/or processes
Proficient in computer software such as: MS Office Skills, specifically PowerPoint and Excel
Can work independently and determine appropriate course of actions
Able to travel up to 25%


Work at Home/Remote Requirements


Must ensure designated work area is free from distractions during work hours and virtual meetings
Must provide a high-speed DSL or cable modem for a workspace (Satellite, wireless and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required


Preferred Qualifications


Bachelor's degree
Experience with data and analysis
Experience in Subrogation, Collection, Prepay or Postpay


Scheduled Weekly Hours

40

Company info

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