Supervisor, Payment Integrity - Appeals & Disputes

About the role

The Supervisor, Payment Integrity – Appeals & Disputes leads clinical coding compliance nurses and non‑clinical team members through the code editing adjudication process. The role ensures production standards, quality audits, and effective communication across health plans, claims, IT and vendors.

Key responsibilities

• Lead the coding compliance team through pre‑pay compliance, adjustments and appeals using multiple code editing software systems.
• Ensure the Coding Analytics team meets production standards and passes quality audits.
• Oversee relationships with health plans, claims departments and other internal groups to meet key performance indicators.
• Research coding questions, provide expert testimony in state hearings and resolve escalated inquiries.
• Act as health‑plan account liaison, lending expertise to code‑editing decisions.
• Communicate across IT, vendors and affected departments and perform other duties as assigned.

Required profile

• Associate’s degree in Medical Billing and Coding, Healthcare or related field (or equivalent experience).
• 5+ years of experience in account management, nursing, healthcare management, medical billing, CPT coding, claims analysis or data management.
• Current RN license or Certified Professional Coder (CPC) preferred.

Required skills

• Proficiency with code editing software systems.
• Strong knowledge of CPT coding.
• Medical billing expertise.
• Experience in coding analytics and data management.

What we offer

• Competitive salary range $70,100 – $126,200 per year.
• Comprehensive health insurance, 401K and stock purchase plans.
• Tuition reimbursement and paid time off plus holidays.
• Flexible work options including remote, hybrid, field or office schedules.
• Inclusive culture committed to diversity and equal opportunity.