Remote Payment Integrity Lead, Quality & Appeals

CorVel Corporation; Fort Worth (TX); Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Comprehensive benefits package

401K and ROTH options

Paid time off

Job summary

A leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations of the payment integrity team. Responsibilities include managing quality assurance measures and resolving provider appeals. The ideal candidate will also ensure compliance with healthcare auditing standards and maintain a focus on improving service delivery. This remote position requires strong experience in claims processing and excellent communication skills. Candidates must hold an Associate Degree in Nursing and RN licensure.

Qualifications

• 5+ years of experience in acute clinical areas preferred.
• 2+ years of supervisory or management experience required.
• Demonstrated knowledge of CMS guidelines and ICD-10 coding.

Responsibilities

• Supervises daily activities of the payment integrity team.
• Manages staff assignments to ensure timely processing.
• Continually improves service delivery to customers.

Skills

Claims processing

ICD-10 Coding

Healthcare claims reimbursement

Microsoft Office Suite

Complex problem-solving

Effective communication

Attention to detail

Education

Associate Degree in Nursing

Current RN licensure

Tools

Microsoft Excel

Microsoft Word

Job description

A leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations of the payment integrity team. Responsibilities include managing quality assurance measures and resolving provider appeals. The ideal candidate will also ensure compliance with healthcare auditing standards and maintain a focus on improving service delivery. This remote position requires strong experience in claims processing and excellent communication skills. Candidates must hold an Associate Degree in Nursing and RN licensure.