AVP Payment Integrity Operations

Job Description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members.

The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics.

Sagility has more than 25,000 employees across 5 countries.

Job title:

AVP Payment Integrity Operations

Job Description:

Sagility is a tech-enabled BPM services provider, a thought partner providing a broad spectrum of transformational services, to enable our clients provide efficient and hi-quality care across the healthcare system.

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members.

We optimize the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics.

Leading industry analyst firms have consistently cited our service excellence, breadth of offerings, and ability to execute.

The most recent being recognized as a leader for Healthcare Payer Operations in 2022 as a part The Healthcare Payer Operations PEAK Matrix Assessment report by Everest Group.

We have 35,000+ employees in 15 cities across 5 countries ? India, Philippines, USA, Jamaica, and Colombia.

About SPIS ( Sagility Payment Integrity Services)

Sagility?s approach to Payment Integrity (PI) is a collaboration between our data mining, coding and clinical teams that provides predictable operational excellence through analytics-led, technology-driven solutions.

Backed by our proprietary Intelligent Content Processing (ICP) software, we deliver high quality, broad automation driven by more accurate findings.

Through our HITRUST certified platform, Contract Central, we provide Data Mining, Clinical Audit and Claims Repricing solutions that enhance claims payment accuracy and ensure significant savings in both pre and post-pay.

Sagility is currently hiring for a talented Associate Vice President (AVP) of Payment Integrity Operations.

This role will oversee and manage the operational activities related to payment accuracy, 燼nd cost containment across various payment systems for a portfolio of Data Mining clients.

This leader will be responsible for ensuring the efficient, effective, and compliant operation of payment integrity functions within the organization in collaboration with other AVP?s who manage another set of clients.

燭he incumbent will collaborate with cross-functional teams to drive operational excellence, increased automation, implement strategic initiatives, and ensure achievement of company and client specific financial and quality goals, adherence to policies and regulations.

Job Summary:

The successful candidat...