Director, Payment Integrity & Appeals (Remote)
Centene Corporation
Raleigh, NC
- Remote job
Centene Corporation in North Carolina is seeking an experienced Prepay Compliance leader to oversee prepay waste and abuse reviews, edit and audit programs, and ensure payment integrity. You will guide policy design and staff through complex regulatory requirements. The role requires a Bachelor’s degree and 7+ years in finance, auditing, or healthcare operations, with a track record in claims processes. A flexible work approach and collaboration with senior management are expected. #J-18808-Ljbffr Centene Corporation
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Director, Payment Integrity & Appeals (Remote) in Raleigh, NC vacancy
- ...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 LLCRemote job
$107.7k - $199.3k
...retrospective audits to ensure accurate and timely payments of coding and pricing issues Interpret... ...develop, and implement internal payment integrity edit and audit programs, policies, and... ..., and a flexible approach to work with remote, hybrid, field or office work schedules....Remote workFull timePart timeWork at officeFlexible hours- ...seeking a lead for prepay waste and abuse reviews, overseeing coding, editing, and audit programs to ensure compliant and timely payments. The role involves guiding policy, training, and continuous process improvement across payer operations. The ideal candidate has 7...Remote job
$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- 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
- ...company standards, while guiding a team to reduce waste and fraud. This role requires strong audit analysis and a strategic view of payment integrity. 7+ years in finance, accounting, or auditing, with a bachelor’s degree in a related field. #J-18808-Ljbffr Centene...
- ...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
- ...Bonus! Job Summary ~ The Senior Director of Revenue Integrity leads the identification and resolution... ...contract variances and support bulk appeals. Operational Leadership and Process... ...resumes. Solicitation of Payment Ventra Health does not solicit payment...Remote workContract workPrivate practiceFlexible hours
Ventra Health, Inc.
United States2 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$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$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$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$194.8k - $292.2k
...ambitious startups - use Stripe to accept payments, grow their revenue, and accelerate new... ...is available either in an office or a remote location (35+ miles or 56+ km from a Stripe... ...for people with passion, grit, and integrity. You're encouraged to apply even if your...Remote workInternshipWork at officeLocal areaWork from homeRelocationStripe
San Francisco, CA2 days ago$219k
ABOUT THE ROLE Card payments remain the backbone of Uber's global payments volume. As Head... ...rules, processing flows, and technical integrations, as well as the ability to translate payments... ...'s culture. Unless approved for full remote work, employees must spend at least 50%...Remote workFull timeWork at officeShift work- Centene Corp. is seeking a Senior Prepay Compliance Manager to oversee prepay waste and abuse reviews, coding, editing, and audit programs across our payer operations. You will develop policies, monitor regulations, interpret audit results, and present findings to senior...
- ...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...
- CorVel Corporation is seeking a Payment Integrity Analyst to review pre and post pay claim audits... ...and client policies. This is a remote position with responsibilities spanning... ...with preference for experience in denials/appeals. Strong communication and analytical skills...Remote job
$152k - $193k
...building and scaling of our next-generation payments platform, the infrastructure that moves... ..., build, and launch payment methods and integrations across cards, wallets, ACH, cash, and... ...dental, and vision plans ~401(k) ~Remote work environment, with offices in Miami...Remote workFull timeFlexible hoursFelix Technologies, Inc.
Remotea month ago$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
Remotea month ago$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- ...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- ...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
$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- ...Specialist, Talent Acquisition at nTech Workforce Title: Payment Integrity Specialist Location: 100 % Remote, but Candidates must be based in EST or CST and must... ...Previous experience in a Payment Integrity or Appeals unit. Familiarity with NASCO or Conduit (SIR) systems...Remote workContract work
$132k - $162k
...CPAs CHIEF OPERATION OFFICER / INTEGRATOR THE PERSON Are you... ...Doylestown, PA. Open to exceptional remote candidates located within... ...Background in serving as a Director of Operations, Director of Firm... ...bills and making vendor payments, creating invoices, recording...Remote workFull timeFor contractorsFlexible hoursVisionSpark
Philadelphia, PAa month ago$150k - $175k
...Summary The Director of Revenue Cycle Management (RCM... ...operations, revenue integrity, and revenue cycle analytics... ...Claims management Payment posting Denials management Appeals Collections Revenue... ...environment This is a fully remote role Boulder Care...Remote workFull timeTemporary workBoulder Care
United States1 day ago- ...DIRECTOR OF REVENUE CYCLE MANAGEMENT - Chadds Ford,... ...authorizations, claim submission, payment resolution, audits, denial management, and appeals. This position will... ...development and integration of the revenue cycle... ...team members across remote and in-office...Remote workFull timeWork at office
Lympha Press
Chadds Ford, PA3 days ago - IDC seeks a Research Director to lead integration, API management and AI-enablement within the AD&A research domain. You will size markets, forecast growth and analyze market drivers, buyer behavior and business value across middleware technologies. In this role you will...Remote job
- ...an experienced leader to head the Prior Authorization team. This role ensures timely submissions, accurate outcomes, and effective appeals while coordinating with across departments to optimize workflows. Strong focus on clinical relevance and policy adherence guides decision...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Director, Payment Integrity & Appeals (Remote). Be the first to apply!
Related searches
- academic director Raleigh, NC
- director of knowledge management Raleigh, NC
- director of college counseling Raleigh, NC
- director of training and development Raleigh, NC
- director of public safety Raleigh, NC
- director of advocacy Raleigh, NC
- director revenue management Raleigh, NC
- director of community outreach Raleigh, NC
- director mba Raleigh, NC
- director vendor management Raleigh, NC