Director, Global Post-Pay Audit

Health Business Solutions LLC; Town of Florida (NY); Hybrid; USD 180,000 - 240,000; Full time

Job summary

A healthcare consulting firm is looking for an experienced Director of Post-Pay Audit to lead audit teams in both U.S. and Philippines operations. The role involves overseeing comprehensive post-payment audits for various payers, ensuring compliance and maximizing revenue recovery. Candidates should have significant experience in healthcare reimbursement policies and government audit programs. Leadership of cross-functional teams is crucial for this position, along with a strong understanding of healthcare billing and coding systems.

Qualifications

• Minimum of 7–10 years of experience in post-payment auditing, healthcare reimbursement, or revenue recovery.
• Proven experience managing global teams, including operations based in the Philippines.
• Strong knowledge of government audit programs (RAC, MAC, CERT, ZPIC/UPIC, Medicaid audits).
• Excellent understanding of healthcare billing, coding (ICD-10, CPT, HCPCS), and payer policies.

Responsibilities

• Lead and manage the end-to-end post-pay audit function.
• Direct and support a global team of audit professionals.
• Oversee audit processes related to government payers.
• Collaborate with compliance, legal, and analytics teams.
• Build relationships with internal stakeholders and clients.

Skills

Leadership

Analytical skills

Communication

Knowledge of healthcare reimbursement

Process improvement

Education

Bachelor’s degree in Healthcare Administration, Business, Finance, or related field

Master’s or MBA

Tools

Audit and recovery systems

Reporting tools

Workflow platforms

Job description

A healthcare consulting firm is looking for an experienced Director of Post-Pay Audit to lead audit teams in both U.S. and Philippines operations. The role involves overseeing comprehensive post-payment audits for various payers, ensuring compliance and maximizing revenue recovery. Candidates should have significant experience in healthcare reimbursement policies and government audit programs. Leadership of cross-functional teams is crucial for this position, along with a strong understanding of healthcare billing and coding systems.