Director, Payment Integrity: Appeals & Disputes (Remote)
Centene Management Company LLC
Kansas City, MO
- Remote job
Centene Management Company LLC seeks an experienced professional to oversee prepay waste and abuse reviews, coding, editing, and audit programs, ensuring compliance with state and federal regulations. The role includes guiding policy development, presenting findings to senior management, and leading Prepay Compliance Managers to reduce waste, abuse, and fraud. Responsibilities also include designing and implementing payment integrity edits, monitoring regulatory changes, and delivering training #J-18808-Ljbffr Centene Management Company LLC
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Director, Payment Integrity: Appeals & Disputes (Remote) in Kansas City, MO vacancy
$118.4k - $219k
...retrospective audits to ensure accurate and timely payments of coding and pricing issues... ...develop, and implement internal payment integrity edit and audit programs, policies, and procedures... ..., and a flexible approach to work with remote, hybrid, field or office work schedules....Remote workFull timePart timeWork at officeFlexible hoursCentene Corporation
Georgia3 days ago$112.7k - $193.2k
...? Join us to start Caring. Connecting. Growing together.The Payment Integrity Platform organization is responsible for building and scaling... ...technology solution.You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges...Remote workMinimum wageFull timeWork experience placementWork at officeLocal area- ...develop action plans, and present findings to senior management. The role emphasizes developing continuous processes, implementing payment integrity programs, and training providers and employees to streamline operations while maintaining policy adherence. #J-18808-Ljbffr...Suggested
- Optum is seeking a Sr. Technical Product Manager for Payment Integrity to lead strategy and delivery for scalable platform capabilities. This remote role partners with engineering, architecture, operations and business leaders to drive value across multiple portfolios....Remote job
- ...leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations... ...measures and resolving provider appeals. The ideal candidate will also ensure compliance... ...on improving service delivery. This remote position requires strong experience in...Remote jobDaily paid
$123k - $193k
...scaling of our next-generation payments platform, the infrastructure... ...launch payment methods and integrations across cards, wallets, ACH, cash... ...and Operations (payment ops, disputes) to develop scalable... ...vision plans ~401(k) ~Remote work environment, with offices...Remote workFull timeFlexible hoursFelix Technologies, Inc.
Remote6 days ago$206.4k - $258k
..., Denver, CO and Charlotte, NC area) Position Summary The Director, Payment Integrity will build and lead Judi Health's payment integrity program... ..., savings yield, false positive rates, and provider dispute outcomes Compliance and Policy Alignment Ensure all payment...Local areaFlexible hours- ...a Clinical Itemized Bill Reviewer to join our Appeals and Disputes team. You will review disputes tied to Payment Integrity findings, focusing on high-dollar facility claims... ...CPT/ICD-10/HPCS coding guidelines. This is a remote role in the United States. #J-18808-Ljbffr...Remote job
$194k - $291.5k
...platform continues to evolve, payments are central to delivering a... ...is seeking an exceptional Sr Director, Legal, Global Payments to lead... ..., its partners, and the integrity of the platform. What You... ...Applicants for Jobs Located in NYC or Remote Jobs Associated With Office...Remote workFull timeWork at officeLocal areaFlexible hoursSocket.dev
San Francisco, CA3 days ago$200k - $250k
Are you ready to make an impact?Healthcare Payment Integrity DirectorWest Monroe has an immediate opportunity for a Director aligned to the Healthcare Practice. This role will focus on delivering business and technology consulting solutions for payer organizations, with...Local areaImmediate startFlexible hours- The Director, Payment Integrity serves as BCBSA's enterprise leader for advancing a System-wide payment integrity strategy that strengthens affordability across the Blue Cross Blue Shield System. This role is responsible for scoping, planning, and driving strategic PI initiatives...Full timeShift work
- ...DIRECTOR OF REVENUE CYCLE MANAGEMENT - Chadds... ...claim submission, payment resolution, audits... ...management, and appeals. This position... ...continued development and integration of the revenue... ...members across remote and in-office environments... ...review, payer disputes, appeals, and...Remote workFull timeWork at office
Lympha Press
Chadds Ford, PA4 days ago $134.6k - $230.8k
...beyond basic care to health programs integrated across the entire continuum of care. Join... ...-being of the nation's citizens.The Director of Payment Model Technical Assistance will guide... ....You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you...Remote workMinimum wageFull timeFor contractorsWork experience placementFor subcontractorWork at officeLocal area- ...The Opportunity The Integrated BESS Execution Director (Director) provides executive leadership for the... ...teams on contract administration and dispute resolution. Lead development and... ...role will be hybrid: 2 days per week remote, 3 days per week in-office out of the...Remote workContract workFor subcontractorWork at office2 days per week3 days per week
Black & Veatch Family of Companies
Overland Park, KS11 days ago $157.2k - $298.8k
...Sustainment (NSS) / Ship Systems Integration & Sustainment (SSI&S) is looking for an Associate Director, Program Management candidate.... ...as on-site, hybrid or remote. The salary range for this... ...collective-bargaining agreement. Payments under these annual programs are...Remote workFull timeContract workTemporary workWork experience placementWork at officeRelocationRelocation packageFlexible hoursRTX
Arlington, VA3 days ago$130k - $170k
...converting deal rationale into People integration strategies that support... ....Reporting to the Sr. Director, People M&A, you will partner... ...well as any other discretionary payment or compensation program) at any... ..., and market factors.Remote roles are not eligible for U....Remote workWork at officeImmediate startVisa sponsorshipShift work$105k - $135k
...Director of Payor Relations Reports to: Chief... ...of innovation, integrity, and compassionate... ..., and value-based payment arrangements. Analyze... ...issues and disputes. Implement and... ...management reviews, and appeals processes.... ...-based role; some remote work available)....Remote workOngoing contractFull timeContract workBloom Healthcare
Lakewood, CO3 days ago$154.5k - $226.6k
...are building enterprise-grade payment infrastructure to support... ...ground up. Role Overview The Sr. Director, Payment Innovation &... ...card processing, settlements, disputes, chargebacks, and reconciliation... ...Indianapolis or San Francisco. Open to remote with travel. Lilly is...Remote workFull timeContract workH1bVisa sponsorshipWork visaFlexible hoursShift work$7,000 - $8,999 per month
Career Opportunities: Director IV - Consumer Affairs and Appeals (19889) Posting ID 19889 -Posted 08/07/2026 -... ...Retirement plans with lifetime monthly payments after five years of state service,... ...to maintain the security and integrity of the infrastructure per Governor...Remote workFull timeTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$65k - $92k
# Payment Integrity AnalystClinical Audit & Revenue IntegrityRemoteJune 30... ...Job Description**Location:** Remote (US-based)We are seeking a *... ...findings that a medical director will accept on the merits. A... ...adjusting for denial rates and appeal risk.* Produce structured documentation...Remote workHourly payFull timeWork at officeLocal areaWork from homeMonday to Friday$90k - $120k
Recruiter, Payment Integrity Services Job type: Full Time · Department: People Operations ·... ...York, United States; United States (Remote) About Alaffia & Our Mission Every year... ...including specialized areas such as Appeals & Disputes and DRG (Diagnosis-Related Group)...Remote workFull timeWork at officeFlexible hours3 days per week$146.4k - $228.6k
Role Description Payments is one of the biggest, highest stakes areas at Jane. It touches... ...~Champion improvements to our Stripe integration and payments architecture, closing gaps... ...founder-led, high-growth SaaS company with a remote-first team working across Canada, the US...Remote workFull timeJane
Remote3 days ago$87.7k - $157.8k
...workplace flexibility. Remote Role: Minimum... ...Conducting DRG reviews for a Payment Integrity vendor or payer... ...Assurance, Readmissions, Appeals, or broader operational... ...(e.g., Medical Directors, Provider Relations,... ...improvement, complex appeal/dispute review, or auditor...Remote workFull timePart timeWork at officeFlexible hours- ...are currently seeking a Director, State Income Tax to... ...initially support Finance integration initiatives and will... ...returns, estimated payments, extensions, and related... ...audits, examinations, appeals, and controversy... ...many positions offer remote or hybrid work options...Remote workFull timeTemporary workWork at officeLocal areaFlexible hours
$175k - $320k
...and forward-thinking organization, apply now.We are currently seeking a Card & Payments Industry Consulting Director to join our team in the United States (US).***This is a virtual/REMOTE U.S. based role which will require 25-50% variable travel.About NTT DATA’s Card...Remote workTemporary workFlexible hours$157.2k - $298.8k
...adversaries. As the Systems Engineering Integration and Test (SEIT) Integrated Product Team... ...role is designated as on-site, hybrid or remote.The salary range for this role is 157,20... ...covered by a collective-bargaining agreement. Payments under these annual programs are not...Remote workContract workTemporary workWork experience placementWork at officeRelocation packageFlexible hours$100k - $231.54k
...strategic initiatives and programs within the organization. Collaborate with business and Cross Matrixed partners to enhance the Payment Integrity strategy and roadmap; translate and simplify ambiguous problems into frameworks which inform solutions to drive short and long...Hourly payFull timeTemporary workWork experience placementWork at officeLocal area3 days per week- ...together.Find out more:Our approach to R&DJob Title: Senior Director, Portfolio Integration LeadOverview Cancer is unrelenting, but so are we. At GSK... ...offers a hybrid working model, with a mix of on-site and remote work. Remote or fully home-working arrangements are not...Remote workFull timeLocal areaWork from homeRelocation
- Cambia Health Solutions in the United States is hiring a Payment Integrity Nurse I to review post-service claims and ensure accurate coding within defined medical policies. The role supports patient care while maintaining compliance and high-quality review standards. You...Remote jobWork from home
$44.8k - $60k
...IntegrationApplyremote type: Fully Remotelocations: Remote, COtime type: Full timeposted on: Posted... ...of Jesus Christ and, as such, is an integral part of the Christian mission and... ...expense reports* Process contracts, payments, invoices**Key Qualifications*** Deep understanding...Remote workWork at officeLocal areaShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Director, Payment Integrity: Appeals & Disputes (Remote). Be the first to apply!
Related searches
- director of corporate relations Kansas City, MO
- academic director Kansas City, MO
- director of public policy Kansas City, MO
- director of culinary Kansas City, MO
- director of equity and inclusion Kansas City, MO
- residence director Kansas City, MO
- director of grants Kansas City, MO
- rehabilitation director Kansas City, MO
- dance director Kansas City, MO
- director revenue management Kansas City, MO