Director of Payment Integrity

Overseeing prepay waste and abuse reviews, the full-time salaried Director of Payment Integrity will manage coding, editing, and audit programs while ensuring compliance with state and federal regulations in a remote work environment. Key responsibilities Oversee prepay editing and retrospective audits to ensure accurate and timely payments of coding and pricing issues Interpret audit results, develop action plans, and present findings to senior management Develop and implement internal payment integrity edit and audit programs, policies, and procedures Required qualifications Bachelor's degree in Accounting, Finance, Nursing, Operations Management, Healthcare-related field, or equivalent experience 7+ years of finance, accounting, operations, or auditing experience Experience in claims operations preferred 7+ years of compliance or enterprise risk management experience preferred