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Payment Operations Manager Jobs in Rhode Island (NOW HIRING)

Bcbsri

Director Payment Integrity

Providence, RI · On-site +1

$116K - $187K/yr

Manage daily operations of the payment integrity department; lead the strategic program expansion of claims audit and recovery, including all claims editing programs. Foster and maintain ...

Citizens

Senior Risk Manager: Payments

Johnston, RI · On-site

$117K - $153K/yr

Role Summary As a First Line Risk Senior Manager supporting the Treasury and Wholesale Payments ... operational risks across these critical payment channels, including Commercial's Treasury ...

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Payment Operations Manager information

See Rhode Island salary details

$30.4K

$62.1K

$116K

How much do payment operations manager jobs pay per year?

As of Aug 8, 2026, the average yearly pay for payment operations manager in Rhode Island is $62,143.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,200.00 and $75,900.00 per year, depending on experience, location, and employer.

What does a payment operations manager do?

A Payment Operations Manager oversees the day-to-day activities related to processing financial transactions within an organization. They ensure that payments are handled efficiently, securely, and in compliance with relevant regulations. Their responsibilities often include managing a team, optimizing payment processes, handling payment disputes, and working closely with other departments such as finance and compliance. Additionally, they may be involved in implementing new payment technologies and maintaining relationships with banks and payment service providers.

What are some common challenges faced by payment operations managers in ensuring efficient transaction processing?

Payment Operations Managers often encounter challenges such as maintaining accuracy under high transaction volumes, keeping up with ever-evolving compliance regulations, and quickly resolving payment discrepancies. They must also ensure that payment systems are secure and that all team members are trained on the latest protocols. Effective communication and collaboration with IT, finance, and customer service teams are crucial to proactively address issues and maintain smooth payment flows.

What are the key skills and qualifications needed to thrive as a payment operations manager?

To excel as a Payment Operations Manager, you need a strong background in financial operations, payment processing, and risk management, often backed by a degree in finance or a related field. Familiarity with payment platforms (such as SWIFT, ACH, or SEPA), ERP systems, and compliance certifications like AML or PCI DSS are typically required. Outstanding analytical skills, attention to detail, and leadership abilities help in managing teams and resolving complex payment issues efficiently. These skills ensure secure, accurate, and compliant transaction processing, safeguarding the company’s financial integrity and customer trust.
What are popular job titles related to Payment Operations Manager jobs in Rhode Island? For Payment Operations Manager jobs in Rhode Island, the most frequently searched job titles are:
What job categories do people searching Payment Operations Manager jobs in Rhode Island look for? The top searched job categories for Payment Operations Manager jobs in Rhode Island are:
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Payment Operations Manager jobs near you

Claim Auditor Payment Integrity (44544)

Neighborhood Health Plan of Rhode Island

Smithfield, RI • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

The Claim Auditor in Payment Integrity will address problematic and complex audit assignments to identify claim overpayments in accordance with established billing and coding parameters. Claim payment accuracy will be recognized through sound audit review methods and practices, including but not limited to; claim payment evaluation, medical chart review, claim payment data analysis and assessment of established organizational contractual parameters. Independently analyzes, extracts, refines, and interprets claims data for actionable insights. The Auditor uses self-directed, decision making and problem solving that directly impacts financial outcomes and results.
Duties and Responsibilities:
Responsibilities include, but are not limited to:
  • Investigate potential over-utilization by performing audits thought pre and post claim payment.
  • Initiate and verify claims adjustments, maintain audit documentation, and prepare savings reports.
  • Identify new audit areas through data mining and performing sample audits.
  • Develops reports and deliverables for management and communicates with all levels of stakeholders.
  • Provide recommendations and collaborate with Payment Integrity team on audit outcomes, identified issues, recommended modifications to clinical medical policies, billing and reimbursement guidelines, and online provider manual.
  • Serve as contact with all operational areas relevant to Payment Integrity audit decisions.
  • Represent company in internal and external meetings/conference calls when needed to discuss audit results or perform coding education.
  • Performs other duties as assigned

Qualifications
Required:
  • Associate's degree or equivalent of three (3) years of claim review work experience to equate to the degree
  • Experience in medical records review, claims processing or utilization/case management in clinical practice or managed care organization
  • Fundamental knowledge of Medicare/Medicaid Guidelines
  • Experience with provider payment methodologies
  • Critical thinking and judgment/decision making skills
  • Solutions oriented-positive attitude
  • Independent problem solving-innovative thinker
  • Strong communication skills (written/verbal)
  • Excellent Customer Service skills
  • Ability to effectively prioritize and execute tasks in a high-pressure environment
  • Intermediate to Advanced skills in Microsoft Office (Word, Excel, Outlook)
  • Ability to work independently as well as part of a team

Preferred:
  • American Academy of Professional Coder's (AAPC) COC and/or CIC
  • Data analytics experience
  • Knowledge of COGNOS reporting environment

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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