•Ensure legal and regulatory requirements are followed and met in line with CMS and federal policies within
•Develop and prepare teams to undertake new roles for new lines of business in the Payment
Integrity/ Government Operations Appeals & Grievances business areas
•Assist in curriculum build to support MnR, Medicaid and E&I operations across multiple platforms
•Ensure Payment Policies are researched thoroughly and applied correctly for claim denials across all platforms and lines of business when investigating overpayment appeals and claim denial appeals