Prepayment Auditing Manager

Managing the daily operations of prepayment claims auditing programs, the full-time Prepayment Auditing Manager will lead a multidisciplinary team to ensure payment accuracy, vendor compliance, and effective audit strategies while working remotely from Pennsylvania. Key Responsibilities Oversee prepayment claim review processes and vendor management to optimize audit performance and compliance Develop and implement auditing strategies that align with organizational payment integrity objectives and regulatory requirements Manage the audit appeal process, ensuring timely resolutions and collaboration with internal and external stakeholders Required Qualifications Bachelor's Degree in a relevant field or equivalent experience 5+ years of experience in Payment Integrity, Claims Auditing, or Healthcare Compliance 3+ years of leadership experience managing clinical or auditing teams Experience with prepayment review programs and vendor oversight Knowledge of healthcare reimbursement methodologies and claims processing