This is a fully remote position, open to applicants in United States.

• Participate in monthly Business Review meetings with clients, delivering comprehensive and analytical data insights related to carrier engagement.

• Join monthly Carrier meetings to present referral findings and facilitate data-driven discussions.

• Provide hands-on delivery of client medical claims data to both external and internal stakeholders.

• Drive initiatives that enhance trust, transparency, and collaboration with carriers.

• Identify performance gaps and spearhead cross-functional improvement plans.

• Manage escalations and ensure prompt resolution of carrier-related issues.

• Advocate for a consistent, high-quality experience across all interactions with carriers and clients.

• Act as an executive liaison for carrier and client relationships, concentrating on service, performance, and partnership.

• Enhance team capabilities in communication, analytics, relationship management, and problem-solving.

• Bachelor’s degree in business, operations, or a related field; advanced degree preferred.

• 5 - 10+ years of experience in payment integrity operations, clinical coding, or account management.

• Proven experience managing the payment integrity operations process, workflow patterns, and complex operational programs.

• Strong skills in data analytics, utilization of data visualization tools, relationship building, problem-solving, and process improvement.

• None stated

Director of Payment Integrity

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