支付完整性概念开发专家
Payment Integrity Concept Development SME
职位描述：支付完整性概念开发主题专家（SME）负责设计、开发和验证创新的支付完整性概念，以识别不准确、不适当或缺乏支持的医疗索赔。该职位需要结合医学编码、报销方法、临床文档、监管指导和索赔分析方面的专业知识，开发高价值的超额支付检测机会，从而实现可衡量的成本节约。
理想的候选人应有成功从初步想法到实施开发新的支付完整性概念的经验，实现显著的财务追回，同时保持高临床准确性并降低对提供方的摩擦。
*基本薪资范围：75,100 - 107,300美元/年
有关福利和我们提供的更多信息，请访问我们的网站
最初发布于喜马拉雅山
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The Subject Matter Expert (SME) – Payment Integrity Concept Development is responsible for designing, developing, and validating innovative payment integrity concepts that identify inaccurate, inappropriate, or unsupported healthcare claims. This individual combines deep expertise in medical coding, reimbursement methodologies, clinical documentation, regulatory guidance, and claims analytics to develop high-value overpayment detection opportunities that generate measurable savings.
The ideal candidate has a proven history of successfully developing new payment integrity concepts from initial idea through implementation, resulting in significant financial recoveries while maintaining high clinical accuracy and low provider abrasion.
*Base Pay Range: $75,100 - $107,300/yr
For more information on benefits and what we offer please visit us at
Originally posted on Himalayas