Payment Accuracy and Concept Lead, AI-Driven
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Job Description
Payment Accuracy and Concept Lead at Bluespine focused on detecting medical billing errors and fraudulent patterns. Collaborating with various teams to drive impactful results and create new audit concepts.
Responsibilities:
- Leverages the Bluespine platform to develop and refine new audit concepts in healthcare
- Leads concept creation across multiple audit verticals
- Works closely with Medical Coders, Data Sciences, and Engineering teams to ensure alignment and drive impactful results
- Lead in-depth research of new ideas and concepts
Requirements:
- Extensive knowledge of medical terminology
- Previous auditing or consulting experience in a provider or payer environment is preferred
- Registered Nurse required; Bachelor's or Graduate degree
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