Partner with Product, Engineering, Data Science, Operations, Partnerships, and other Risk teams to scope, prioritize, and deliver fraud mitigation work.
Partner with Product, Engineering, Data Science, Operations, Partnerships, and other Risk teams to scope, prioritize, and deliver fraud mitigation work.
Coach and support all PI Pre-Payment team members to monitor and identify non-compliance in billing and claims payment activity within the international markets.
Oversee departmental personnel matters; evaluating staff performance and conducting performance appraisals for all direct reports. Ensure adherence to company practices and procedures.
Conduct claimant, provider or third‑party interviews where required, ensuring adherence to investigation protocols, professionalism and non‑tipping‑off principles
Ensure all the Authorization Standard Operating Procedures & Policies (SOPP) are adhere to and maintain unhindered operations of authorization meeting all department objectives.
Conduct claimant, provider or third‑party interviews where required, ensuring adherence to investigation protocols, professionalism and non‑tipping‑off principles