Payment Integrity Program Architect

Devoted Health Services, Inc; Waltham (MA); Hybrid; USD 73,000 - 120,000; Full time

Benefits offered by this job

Employer-sponsored health, dental, and vision plans

Generous paid time off

Stock options for all employees

401(k) plan

Job summary

Devoted Health Services, Inc in Waltham, MA is seeking a Payment Integrity Program Development Manager responsible for designing innovative concepts across payment edits and audits. You will manage the full lifecycle of edit development and ensure claims are paid accurately while serving as an expert in coding regulations.

The ideal candidate will have a Bachelor’s degree and a minimum of 4 years in the healthcare revenue cycle. The role offers a salary range of $73,000 to $120,000 based on experience and qualifications.

Qualifications

• Minimum of 4 years relevant experience in a healthcare revenue cycle environment.
• Proven expertise in interpreting CMS policies, NCCI bundling edits, and provider manuals.
• Strong ability to write logic rules for claims processing.

Responsibilities

• Manage the full lifecycle of edit and audit development.
• Design payment policies that supplement CMS guidance.
• Run data queries to validate the financial validity of coding.

Skills

Coding and billing regulations expertise

Analytical literacy

Problem-solving

Education

Bachelor’s degree

Job description

Devoted Health Services, Inc in Waltham, MA is seeking a Payment Integrity Program Development Manager responsible for designing innovative concepts across payment edits and audits. You will manage the full lifecycle of edit development and ensure claims are paid accurately while serving as an expert in coding regulations.

The ideal candidate will have a Bachelor’s degree and a minimum of 4 years in the healthcare revenue cycle. The role offers a salary range of $73,000 to $120,000 based on experience and qualifications.