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Payment Accuracy Manager, Outpatient Facility
Location
United States
Posted
6 days ago
Salary
Not specified
Seniority
Senior
Job Description
Job Requirements
- 5-7 years of experience in payment integrity at a health plan, claims editing vendor, or similar healthcare organization with focus in outpatient facility claims editing and reimbursement methodologies
- Active coding certification (COC, CPC, CCS, or equivalent specialty certification) — required for this position
- Proven expertise in:
- Interpreting medical and payment policies
- Applying CMS and Medicaid reimbursement guidelines
- Professional and outpatient coding standards
- Common claims payment error identification and resolution
- Demonstrated ability to advise clients and explain complex payment accuracy concepts in clear, accessible terms
- Strong analytical skills with experience quantifying policy impact and ROI
- Track record of managing claims editing implementations or similar client-facing initiatives
- Intermediate Excel skills (i.e., formulas, v-lookups, pivot tables, etc)
Benefits
- Health insurance
- Professional development opportunities
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