Payment Selections Manager
C
Cohere HealthHealthcare Technology
Location: United StatesFull-TimeManager
Salary110,000 - 122,000 USD per year
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Job Details
- Experience
- 8+ years
- Required Skills
- Data AnalysisMicrosoft Excel
Requirements
- 8+ years of experience in claims auditing, data analysis, or payment integrity concept design.
- Demonstrated expertise within a healthcare or payer environment.
- Active certified coder credential (e.g., CPC, CCS, RHIA, or RHIT).
- Proficiency with Microsoft Excel (advanced level).
- Understanding of healthcare revenue cycles.
- Ability to balance individual technical contributions with managerial duties.
- Bachelor’s or Associate’s degree in Health Information Management, Health Informatics, or a related field.
Responsibilities
- Research and document new payment integrity concepts by analyzing medical policies, billing regulations, and reimbursement logic.
- Translate complex billing rules into precise technical specifications for automated claim auditing algorithms.
- Perform expert-level claims auditing to validate potential improper payment scenarios.
- Conduct hands-on data analysis using Microsoft Excel to quantify savings potential.
- Collaborate as primary liaison between the team, IT, and the Director of Payment Solutions.
- Continuously identify opportunities to improve internal processes and workflows.
- Maintain deep expertise in ICD-10, CPT, HCPCS, and payer reimbursement methodologies.
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