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Remote Integrity Services Jobs in California (NOW HIRING)

SpaceX

Platform Integrity Manager (Starlink)

Hawthorne, CA · On-site +1

$135K - $200K/yr

PLATFORM INTEGRITY MANAGER (STARLINK) At SpaceX, we are committed to ensuring the service remains a ... This position is based in Hawthorne, CA and requires being onsite-remote work not considered * Must ...

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Remote Integrity Services information

What are Remote Integrity Services?

Remote Integrity Services refer to solutions and processes designed to monitor, assess, and ensure compliance, honesty, and ethical practices within an organization or system from a remote location. These services may include fraud detection, risk assessments, compliance audits, and policy enforcement conducted virtually or offsite. They are commonly used in industries such as online gaming, finance, and corporate governance to maintain trust and prevent misconduct without the need for in-person oversight.

What are the key skills and qualifications needed to thrive in Remote Integrity Services, and why are they important?

To succeed in Remote Integrity Services, you need strong analytical abilities, attention to detail, and a background in compliance, audit, or risk management, often supported by a relevant degree or certification. Familiarity with data analysis tools, case management systems, and regulatory compliance platforms is typically required. Excellent communication, ethical judgment, and problem-solving skills set top performers apart in this role. These competencies are essential to accurately identify and address risks, maintain compliance, and ensure organizational integrity in a remote environment.

What is the difference between Remote Integrity Services vs Remote Security Analysts?

AspectRemote Integrity ServicesRemote Security Analysts
CertificationsISO 27001, CISSP, CISACISSP, CompTIA Security+, CEH
Work EnvironmentRemote, client sites, data centersRemote, cybersecurity firms, IT departments
Industry UsageData integrity, compliance, auditCybersecurity, threat detection, incident response
Job FocusEnsuring data accuracy, compliance, and integrityMonitoring security threats, analyzing vulnerabilities

Remote Integrity Services professionals focus on maintaining data accuracy, compliance, and system integrity, often working with audits and data management. Remote Security Analysts concentrate on protecting systems from cyber threats, analyzing vulnerabilities, and responding to security incidents. While both roles require security-related certifications and often work remotely, their core responsibilities differ: integrity services emphasize data and compliance, whereas security analysts focus on cybersecurity defense.

What are some of the unique challenges faced by professionals working in Remote Integrity Services, and how can they be effectively addressed?

Professionals in Remote Integrity Services often face challenges such as maintaining clear communication with clients and teammates across different time zones, ensuring data security while working with sensitive information remotely, and staying updated on evolving industry regulations. These can be effectively addressed by utilizing secure communication platforms, regularly attending virtual training sessions, and establishing consistent check-ins with the team. Building strong digital collaboration skills and proactively seeking feedback also help in overcoming these challenges and ensuring high standards of integrity in remote work environments.
What are the most commonly searched types of Integrity Services jobs in California? The most popular types of Integrity Services jobs in California are:
What are popular job titles related to Remote Integrity Services jobs in California? For Remote Integrity Services jobs in California, the most frequently searched job titles are:
What job categories do people searching Remote Integrity Services jobs in California look for? The top searched job categories for Remote Integrity Services jobs in California are:
What cities in California are hiring for Remote Integrity Services jobs? Cities in California with the most Remote Integrity Services job openings:
Remote Integrity Services jobs near you

Supervisor, Payment Integrity (Remote)

Molina Healthcare

Long Beach, CA • Remote

$54K - $107K/yr

Full-time

Posted 24 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 197 frontline employees who took The Breakroom Quiz

162nd of 301 rated insurance

Job description

JOB DESCRIPTION Job Summary

Leads and supervises team responsible for payment integrity activities including recovery operations.  Responsible for performance, quality levels and establishing procedures and techniques that achieve optimal payment integrity operational standards and production targets.

Essential Job Duties

Supports implementation and execution of initiatives that include one or all of the following payment integrity activities: overpayment recovery, pre and post-pay coordination of benefits (COB), subrogation, premium enhancement managed service provider (MSP), datamining, pre-pay editing for correct coding and medical payment policies, and supplemental oversight and vendor inventory management processing activities.
Hires, trains, develops, mentors, and manages team responsible for executing projects and activities involving inventory management and prioritization, information reporting, data management, quality control procedures and workflows, and timely turnaround. 
Leads recovery processing, offset reconciliation, refund posting and reconciliation, provider dispute resolution, claim referrals and health plan special projects.
Ensures team meets or exceeds production targets.
Executes payment integrity programs that prioritize, identify and resolve payment/recovery issues.
Establishes procedures and techniques to achieve payment integrity operational standards.
Executes and monitors recovery inventory to ensure maintenance of performance and quality levels in payment integrity business products and processes.
Demonstrates expertise in claims processing, claims payment issue resolution, payment/adjustment error troubleshooting, and quality controls recovery adjustments.  
Professionally communicates and responds to health plan/provider inquiries and understands when to escalate issues for resolution as appropriate.
Manages inventory production queues, and assigns and prioritizes work. 
Analyzes complex data driven reports and develops actionable insights for resolution and leadership reporting. 
Collaborates with payment integrity leadership to resolve recovery issues in collaboration with health plan operations.  
Executes tasks and projects to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, overpayment recovery, COB and subrogation - ensuring improved encounter submissions, general and administrative (G&A) reduction, and positive operational and financial outcomes for the payment integrity function.
 

Required Qualifications

At least 5 years of experience supporting health care operations, including 3 years payment integrity/claims experience, or equivalent combination of relevant education and experience.
Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
Strong organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software program(s) proficiency.
 

Preferred Qualifications

Management/leadership experience.
Managed care payor experience, preferably with Medicare/Medicaid.
Understanding of ICD-9/10CM, MS-, AP- and APR-DRG reimbursement.
Electronic medical record (EMR) and medical record repository experience.
 

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

Social media

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