Lead the Regional Prepayment team who are responsible for identifying claims that should not be paid as received and identify claims with potential Fraud, Waste and Abuse savings to meet Provider Integrity targets and KPIs.
Lead the Regional Prepayment team who are responsible for identifying claims that should not be paid as received and identify claims with potential Fraud, Waste and Abuse savings to meet Provider Integrity targets and KPIs.
Lead the Regional Prepayment team who are responsible for identifying claims that should not be paid as received and identify claims with potential Fraud, Waste and Abuse savings to meet Provider Integrity targets and KPIs.
Achieve continuous improvements in our fraud processes and KPIs (such as fraud rates, false positives, MO defense rates, fraud savings) to achieve the optimum balance between protecting our business from loss, and in promoting growth.