Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment ... Partners with the network team to communicate recovery projects to ensure provider relations is ...
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment ... Partners with the network team to communicate recovery projects to ensure provider relations is ...
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment ... Partners with the network team to communicate recovery projects to ensure provider relations is ...
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment ... Partners with the network team to communicate recovery projects to ensure provider relations is ...
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All work, including remote work, should be performed within Arizona unless an exception is properly ... Responsible for participating in complex and/or field investigative projects that require multi ...
HYDROGEOLOGIST 2 (Adjudications)
Phoenix, AZ · On-site +1
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Web & Marketing Designer
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Ability to multitask across projects with fast turnaround * Excellent communication and ... Self-directed. Remote means remote - you don't need hand-holding to deliver. Nice-to-Haves:
Web & Marketing Designer
Gilbert, AZ · Remote
Ability to multitask across projects with fast turnaround * Excellent communication and ... Self-directed. Remote means remote - you don't need hand-holding to deliver. Nice-to-Haves:
Web & Marketing Designer
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Ability to multitask across projects with fast turnaround * Excellent communication and ... Self-directed. Remote means remote - you don't need hand-holding to deliver. Nice-to-Haves:
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Quick apply
Senior Learning Experience Designer
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This is a remote role and can be located anywhere in the Western Region of the US, located near a ... Asana or similar project management application * Camtasia or other video recording/editing ...
Regional Sales Manager - Carrier Controls
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LEGAL SECRETARY II
Tucson, AZ · On-site +1
$29K - $55K/yr
REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX, TUCSON Categories: Legal/Investigations/Adjustment ... projects as assigned. • Calendar court appearances, hearings, depositions, meetings and other ...
Remote Project Editor information
See Arizona salary details
$34.5K - $41.6K
3% of jobs
$41.6K - $48.6K
13% of jobs
$48.6K - $55.7K
6% of jobs
$58.5K is the 25th percentile. Wages below this are outliers.
$55.7K - $62.8K
7% of jobs
$62.8K - $69.8K
11% of jobs
The median wage is $75.4K / yr.
$69.8K - $76.9K
13% of jobs
$76.9K - $84K
14% of jobs
$84K - $91.1K
5% of jobs
$93.9K is the 75th percentile. Wages above this are outliers.
$91.1K - $98.1K
8% of jobs
$98.1K - $105.2K
11% of jobs
$105.2K - $112.3K
9% of jobs
$34.5K
$77.4K
$112.3K
How much do remote project editor jobs pay per year?
What are Remote Project Editors?
What is the difference between Remote Project Editor vs Remote Content Writer?
| Aspect | Remote Project Editor | Remote Content Writer |
|---|---|---|
| Required Credentials | Editing certifications, writing samples | Writing samples, sometimes a degree in English or Communications |
| Work Environment | Collaborative editing platforms, project management tools | Content management systems, research tools |
| Employer & Industry Usage | Publishing, media, marketing agencies | Blogs, digital marketing, media outlets |
| Search & Comparison Intent | Editing skills, project coordination | Writing skills, content creation |
The Remote Project Editor primarily focuses on reviewing, editing, and refining content across various projects, ensuring quality and consistency. In contrast, a Remote Content Writer is responsible for creating original content from scratch. Both roles often require strong writing skills, but the Project Editor emphasizes editing and project management, while the Content Writer emphasizes content creation. Understanding these differences helps job seekers target the right roles based on their skills and career goals.
How to make 2000 a week working from home?
How does a Remote Project Editor typically coordinate with authors and other team members in a virtual environment?
What kind of jobs in media bring in $150,000 a year?
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What are the key skills and qualifications needed to thrive as a Remote Project Editor, and why are they important?
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Lead Overpayment Recovery Analyst, Payment Integrity - Health Plan (Remote)
Passport Health Plan by Molina HealthcarePhoenix, AZ • Remote
Full-time
Posted yesterday
Job description
JOB DESCRIPTION Job Summary
Provides lead level analyst support for health plan payment integrity activities. Partners with leaders and functional representatives to drive health plan financial performance through evaluation and execution of operational initiatives tied to payment integrity (PI) and provider claims accuracy. Makes recommendations that inform decisions which contribute to health plan strategy, and acts as a trusted voice in assessing and assisting resolution of complex business challenges that impact cost-containment and regulatory compliance.
Essential Job Duties
Business Leadership & Operational Ownership
Assists with and executes projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, post-payment datamining, and overpayment recovery, to improve encounter submissions, reduce general and administrative (G&A) expenses, and drive positive operational and financial outcomes for all payment integrity (PI) solutions.
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment recovery initiatives to ensure health plan SAI targets are met.
Leads efforts to improve claim payment accuracy and financial performance without needing extensive oversight.
Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
Serves as a thought partner to health plan leadership and provides well-reasoned recommendations that support short- and long-term business goals.
Partners with the network team to communicate recovery projects to ensure provider relations is informed and able to respond to provider inquiries.
- Analyze data to identify and develop new recovery opportunities
- Analyze data from Payment Integrity and Vendors against contracts, billing, and processing guidelines
- Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
- Conduct peer reviews of recovery concepts and offer recommendations for logical improvements; assist team members in their analysis of data sets and trends.
- Responsible for documenting policies and procedures related to concept approvals
- Conduct trainings and prepare training documentation for teams
- Other duties as assigned
Strategic Business Analysis
Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps.
Applies understanding of health care regulations, managed care claims workflows, and provider reimbursement models to shape payment integrity related recommendations and action plans.
Translates strategic needs into clear requirements, workflows, and solutions that drive measurable improvement.
Partners with finance and compliance to develop business cases and support reporting that ties operational outcomes to financial targets.
Applied Analytical Support
Uses data analysis tools/systems to support business analysis.
Validates findings and tests assumptions through data, and leads with contextual knowledge of claims processing, provider contracts, and operational realities.
Creates succinct summaries and visualizations that enable faster leadership decision-making.
Required Qualifications
At least 4 years of business analyst experience in a managed care organization (MCO), and at least 2 years of experience in Medicaid and/or Medicare programs, or equivalent combination of relevant education and experience.
Proven experience owning operational projects from concept to execution, especially in the areas of provider reimbursement and claims payment integrity.
Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules.
Strong data analysis/queries experience, and ability to analyze data to inform business decisions.
Strong business judgment, cross-functional coordination, and ownership of high-value deliverables.
Demonstrated ability to work independently and apply business judgment in a highly regulated, cross-functional environment.
Strong written and verbal communication skills, including ability to synthesize complex information.
Microsoft Office suite (including advanced Excel), and applicable software program(s) proficiency.
- Claims processing background
- Experience with Medicare, Medicaid, and/or Marketplace lines of business.
- Payment integrity (PI) programs
Preferred Qualifications
Experience with Medicare, Medicaid, and/or Marketplace lines of business.
Certified Business Analysis Professional (CBAP) or Certified Coding Specialist (CCS) certification.
Project management experience.
Familiarity with Medicaid-specific scorable action items (SAIs), operational cost-management efforts, payment integrity (PI) programs, and regulatory/compliance adherence.
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: $83,252 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.