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23/11 Reena Gonsalves
Manager – Client Success & Delivery at Innoquest Consulting

Views:665 Applications:30 Rec. Actions:Recruiter Actions:5

AVP - Healthcare Payment Integrity (12-20 yrs)

Bangalore Job Code: 1341207

Shift: US Shift/Work from Office

Mandatory ask: 12-20 years overall US Healthcare experience with minimum of 7-10 years in Payment Integrity.

Role Profile:

- As an Ops Leader manage large US Healthcare teams of 500-1000.

- Oversee the accurate and timely processing of healthcare claims, ensuring adherence to relevant payment policies, contractual obligations, and industry standards.

- Exceptional in PI domain and understands the entire landscape of PI as a market (Claims and Clinical).

- Identify opportunities to reduce healthcare costs through improved payment integrity processes, such as targeted audits, recovery efforts, and cost containment measures.

- P&L Management (Revenue management, Cost Optimization, Improvements).

- Identifying Transformational Value Creation via RPA and Analytics offerings.

- Track program performance and its impact on the financial goal.

- Delivering Highest Level of Service Delivery requirements.

- Mentoring & Coaching Operational & Leadership values.

- Creating strong client partnerships

- Exposure, experience and knowledge of Medical Coding, Nursing (NCLEX) and customer outreach experience.

Women-friendly workplace:

Maternity and Paternity Benefits

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