Remote Manager - Payment Integrity Auditing

Premera; United States; On-site; USD 119,000 - 231,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

401K employer match

Tuition assistance

Pension plan after 3 years

Paid time off

Remote-friendly work options

Job summary

Premera is seeking a Manager of Payment Integrity Auditing to lead a team of clinical coding and payment integrity auditors, ensuring accurate reimbursements and regulatory compliance.

You’ll develop audit strategies across DRG validation, itemized bill reviews, and pre-/post-payment initiatives, monitor performance, and drive data-driven improvements while collaborating with leadership. This remote role offers growth and impact across healthcare reimbursement.

Qualifications

• Bachelor's Degree or 8 years of relevant work experience required.
• 5+ years of analytical experience in healthcare or business disciplines.
• 3+ years of leading medium to large-scale payment integrity projects.
• Certified Professional Coder designation or 6+ years of payment integrity experience.

Responsibilities

• Lead a team of clinical coding and payment integrity auditors.
• Direct work on payment integrity auditing processes and systems.
• Set team priorities and manage scope of projects.
• Hire, develop, supervise, and evaluate staff with coaching.
• Communicate strategic direction across departments.
• Provide guidance on complex payment integrity issues.

Skills

Analytical skills

Leadership

Communication skills

Problem-solving

Project management

Microsoft Office Suite

Education

Bachelor's Degree or 8 years of relevant work experience

Tools

Premera claims processing system

Healthcare claims software

Job description

Premera is seeking a Manager of Payment Integrity Auditing to lead a team of clinical coding and payment integrity auditors, ensuring accurate reimbursements and regulatory compliance.

You’ll develop audit strategies across DRG validation, itemized bill reviews, and pre-/post-payment initiatives, monitor performance, and drive data-driven improvements while collaborating with leadership. This remote role offers growth and impact across healthcare reimbursement.