Supervisor, Payment Integrity - Appeals & Disputes

Location: Remote-MO

Salary: $70,100–$126,200 per year

Company

hirify.global connects people to healthcare services and works to make care more accessible and effective.

What you will do

• Lead clinical coding compliance nurses and non-clinical team members through prepay compliance, adjustments, appeals, and code-editing adjudication.
• Ensure the Coding Analytics team meets production standards and passes quality audits.
• Manage relationships with health plans, Claims, IT, vendors, and other affected departments.
• Research coding questions, resolve escalated health plan and provider issues, and identify operational efficiencies.
• Serve as a health plan account liaison and provide expert testimony at state fair hearings and to health plan leadership.

Requirements

• Associate’s degree in Medical Billing and Coding, Healthcare, a related field, or equivalent experience.
• 5+ years of experience in account management, nursing, healthcare management, medical billing, CPT coding, claims, coding analysis and trends, or data management.
• Current state RN license or Certified Professional Coder certification preferred.
• Experience with code-editing software systems in a managed care organization preferred.

Culture & Benefits

• Full-time employment with a flexible remote, hybrid, field, or office work approach.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Equal opportunity workplace committed to diversity and consideration of qualified applicants under applicable law.