Job Description

Job Title: Director of Payment Integrity

Location: Dallas TX

Hire Type: Full Time

Start Date: TBD

Shift Timings: 8:00 AM - 5:00 PM

***Will have to be onsite at least SIX DAYS a month.***

Salary Offered: $64/hour. to $96/hour. on w2

Job Description:

• Five (5) years of management experience - Required.
• Eight (8) years of experience in Payment Integrity Audit and Recovery with knowledge of audit strategies such as Data Mining, Clinical Medical Record Review, and Bill Audit Recovery/Program Integrity experience - Strongly Preferred.
• 2 years of experience in a Managed Care health plan or state agency - Required.
• Knowledge of ICD-10 and CPT/HCPC coding guidelines and terminology - Required.
• Eight (8) years of experience in a comparable position working in Texas Medicaid or Medicaid Managed Care may be considered in lieu of a bachelor’s degree.
• 5 Years of Texas Medicaid, Managed Care Health Plan or State agency experience - Required. ***Please list the types of Medicaid Health Plans that your candidate is familiar with.***
• ***HM looking only considering candidates who actually have payment integrity, rather than revenue recovery experience. Payer-focused on preventing overpayments and preventing fraud, waste, and abuse. Health Plan experience, not healthcare system experience.***

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