Payment Integrity Program Development Senior Manager – Clinical & Facility Specialist

Added
2 hours ago
Location
Type
Full time
Salary
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Related skills

rn medicare ncci ccs rhia

📋 Description

  • Identify new payment integrity opportunities across inpatient, outpatient, ASC, and professional
  • Design automated payment logic translating policies into claims-edit rules.
  • Validate concepts with real-world claims and data analyses.
  • Lead cross-functional policy development with senior leaders and stakeholders.
  • Own concepts from discovery to optimization across care settings.

🎯 Requirements

  • Active RN license with inpatient clinical experience and CPC/CCS/CCS-P/RHIA coding cert.
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