Medical Director - Payment Integrity Services

 Posted 3 months ago
     
 $215K - $290K per year
  
5-10 years experience
Apply Now

Please mention DailyRemote when applying

AI Summary

The Medical Director ensures claims are paid accurately, appropriately, and in full compliance by leveraging clinical expertise, managed care experience, and deep understanding of payer guidelines and regulatory requirements. This role involves collaborating with leaders and analytics partners to connect clinical insight with business strategy and shape payment integrity program responses to emerging changes.

Salary Range:  $215,000 - $290,000

 

As Medical Director – Payment Integrity at EXL Health, you sit at the intersection of clinical practice, payor operations, and financial stewardship.  You leverage your clinical expertise, managed care experience, and deep understanding of payer guidelines, regulatory requirements, and industry-standard policies to ensure claims are paid accurately, appropriately, and in full compliance with state, federal and plan-specific policies.   In this role, every decision influences how healthcare dollars are safeguarded and allocated, making you a key clinical authority within EXL’s Payment Integrity team. 

You collaborate closely with senior leaders, analytics partners and Operations teams to connect clinical insight with business strategy.  When coding changes, regulatory updates, or new data patterns emerge, you help interpret their clinical impact and shape how our payment integrity programs respond, contributing to the evolution of new concepts and solutions. 

 

Similar Jobs

See all Remote Healthcare jobs →

Personalize your Remote Job Search in 3 Easy Steps!

Discover remote opportunities in Medical Director

Answer easy questions

Answer easy questions

200,000+ jobs across 15+ categories

Get your best job matches

Get your best job matches

Only hand-screened, legit jobs

Find a remote job faster

Find a remote job faster

No ads, scams, or junk

I was the first applicant for a remote marketing position that got listed on the company website the same day I applied. Had an interview within 48 hours!

Sarah J. — Sarah J. · Marketing Manager ★★★★★ Verified