Position Overview
JOB DESCRIPTION Job Summary
Leads and supervises team responsible for payment integrity activities including recovery operations. Responsible for performance, quality levels and establishing procedures and techniques that achieve optimal payment integrity operational standards and production targets.
**Essential Job Duties**
• Supports implementation and execution of initiatives that include one or all of the following payment integrity activities: overpayment recovery, pre and post-pay coordination of benefits (COB), subrogation, premium enhancement managed service provider (MSP), datamining, pre-pay editing for correct coding and medical payment policies, and supplemental oversight and vendor inventory management processing activities.
• Hires, trains, develops, mentors, and manages team responsible for executing projects and activities involving inventory management and prioritization, information reporting, data management, quality control procedures and wo...