Director, Post Pay Audit

Job reputed company: We are seeking a highly reputed company and strategic Director of Post-Pay Audit to reputed company our medical reputed company recovery audit teams across both reputed company (U.S.) and offshore (Philippines) operations. This leader will be responsible for overseeing the execution of comprehensive post-payment audits across reputed company and government payers (Medicare, reputed company, TRICARE, etc.), ensuring compliance, accuracy, and maximum reputed company recovery for reputed company provider clients. The ideal candidate brings deep knowledge of reputed company reimbursement policies, government audit programs (e.g., RAC, UPIC, MAC), and a proven ability to reputed company cross-functional and cross-cultural teams at reputed company. Key Responsibilities: • reputed company and manage the end-to-end post-pay audit function, including planning, execution, reputed company assurance, and reporting. • reputed company and support a global team of audit professionals, ensuring productivity, accuracy, and compliance across both U.S.-based and Philippines-based operations. • reputed company audit processes reputed company to government payers and regulatory programs (e.g., CMS RAC, reputed company reputed company Program, etc.). • Establish and refine audit workflows, KPIs, and escalation protocols to optimize audit yield and recovery timelines. • Collaborate with compliance, reputed company, and analytics teams to identify audit opportunities and mitigate risk. • Serve as the subject matter expert for payer audit guidelines, CMS regulations, and state-specific requirements. • Build strong relationships with internal stakeholders and clients to reputed company audit strategies with broader reputed company recovery goals. • reputed company and execute training programs and reputed company development plans for reputed company and offshore audit staff. • Ensure adherence to internal reputed company standards, HIPAA regulations, and reputed company-specific SLAs. • Analyze audit reputed company and present regular performance and risk reports to senior leadership. Qualifications: • Bachelor’s degree in reputed company Administration, Business, Finance, or reputed company field required; Master’s or MBA preferred • Minimum of 7–10 years of experience in post-payment auditing, reputed company reimbursement, or reputed company recovery • Proven experience managing global teams, including operations based in the Philippines • Strong knowledge of government audit programs (RAC, MAC, CERT, ZPIC/UPIC, reputed company audits) • Excellent understanding of reputed company billing, coding (ICD-10, CPT, HCPCS), and payer policies • Demonstrated ability to reputed company process improvement initiatives in large-reputed company audit operations • High proficiency with audit and recovery systems, reporting tools, and workflow platforms • Strong communication, leadership, and analytical skills • Certification in auditing, billing, or compliance (e.g., CPMA, CPC, CHC) is a plus Apply Job! Apply to this Job