Senior Claims Audit & Compliance Lead
Providence Health Plan Group
- p Providence Health Plan Group is seeking an experienced professional to lead the claims internal audit functions, overseeing audit processes for adjudicated claims and encounters. You will monitor check runs for accuracy and develop policies and procedures to ensure compliance with affiliated health plans, client groups, and contractual agreements.
- p The role includes designing and directing claims training programs, ensuring updates align with changing policies, procedures, and technologies. You should be familiar with state and federal claim payment and denial timeliness regulations, as well as the Provider Dispute Resolution tracking AB1455. Join Providence's mission-driven culture focused on patient care and collaboration.
Vacancy posted 1 day ago
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