Devoted Health
Senior Manager, Payment Integrity and Provider Escalation
$110K–$150K
Remote USA · Manager · Full-time · Posted Oct 16, 2026
- Experience
- 5+ years in healthcare PI and dispute-related work; 3+ years of supervisory or people management experience.
About the job
Leads payment integrity disputes and appeals operations, analyzes claim trends and root causes, resolves provider escalations, and uses findings to improve policies, audits, and provider education.
What you'll do
- Oversee dispute and appeal teams, queue performance, quality assurance, training, and SLA compliance.
- Analyze claim disputes and trends; advise upstream payment integrity teams on edits, audits, and policy improvements.
- Manage complex provider escalations, leadership reporting, audit readiness, and provider education.
What they ask for
- 5+ years of healthcare payment integrity, provider disputes, coding/clinical documentation review, or claim audit operations.
- 3+ years of supervisory or people management experience.
- Expertise in CMS regulations and coding, including CPT, HCPCS, ICD-10, UB-04, NCCI edits, and NCD/LCD guidelines.
- Strong analytics, operational leadership, and cross-functional communication skills.
Nice to have
- Active medical coding certification from AAPC or AHIMA (e.g., CPC, CIC, COC, or RHIA/RHIT).
- Experience with LLMs, AI-driven claim intake, automation (RPA), SQL, Tableau, Power BI, or claim editing engines.
Pay
$110,500 - $150,000 /year (base salary)
Tools
CMS, CPT, HCPCS, ICD-10, UB-04, NCCI, SQL, Tableau
AI focus
Identify opportunities to use AI tools, automation, and LLM-assisted workflows to accelerate research, improve log quality, and streamline operations.
Model-written summary · the original posting is authoritative