Director

• Oversee retrospective clinical audits to ensure accurate and timely payment of claims
• Interpret review results, develop action plans and present findings to senior management
• Develop and implement continuous processes from analytic design to final report stage
• Design, develop, and implement internal audit programs, policies, and procedures
• Monitor laws and regulations that may impact policies and procedures and implement changes while maintaining compliance
• Recommend process improvement to assist in developing and executing strategic initiatives and goals
• Develop and deliver educational training programs to providers and employees to streamline operational processes and ensure accurate coding
• Performs other duties as assigned
• Complies with all policies and standards

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