Claims Operations Process Designer

Job SummaryOscar Health seeks a highly skilled Claims Process Improvement Lead to optimize our claims adjudication platform and drive operational efficiency.This is an exciting opportunity to join a forward-thinking company that's disrupting the health insurance industry. As a key member of our Claims Design team, you'll work closely with cross-functional...

Job Title: Claims AdministratorAbout the Job:This role involves timely processing and managing of clients' Victim Compensation Fund claims. As a Claim Administrator, you will work with the VCF Team to ensure that all claims are properly recorded in our systems and that all information has been correctly submitted on behalf of the client to the VCF.The...

About the RoleGlobal Channel Management is seeking a skilled Cash Claims Processor to join our team. As a key member of our operations, you will play a critical role in processing transactions, applying cash, and managing member bills.Salary InformationThe estimated annual salary for this position is $60,000 - $80,000, depending on experience.Job...

Job Description:At Ascot Group, we're seeking a highly experienced Vice President, Claims TPA Manager to lead our Third-Party Administrator (TPA) management team. This role involves providing strategic direction for our programs and captives, collaborating with internal and external partners on TPA management and claims operations.Key Responsibilities:Lead...

We are seeking a Claims Operations Expert to join our Finance team at Progyny. In this role, you will be responsible for analyzing claims data using Excel and SQL to identify corrective action plans to address root issues, and creating various revenue and claims reports for key stakeholders in the Finance department.The ideal candidate will have a strong...

Claim Management OpportunityJoin our dynamic team as a P&C Claims Team Lead! In this role, you will be responsible for leading a team of claim adjusters and overseeing the claims process from start to finish.Main Tasks:Lead a team of claim adjusters to investigate and settle insurance claimsDevelop and implement strategies to improve claim handling and...

Job Description">Oscar Health is a leading healthcare provider seeking a seasoned professional to fill the role of Vice President, Claims System Configuration. As a key member of our team, you will play a crucial part in shaping our claims and benefits configuration strategy, ensuring accurate payments, and enhancing member and provider experiences.">The...

ResponsibilitiesDefine and refine requirements related to claims processing through collaboration with business teams, clients, and technical stakeholders.Translate business needs into detailed user stories and acceptance criteria.Leverage deep knowledge of claims management workflows to identify and implement process improvements.Design and configure SCE...

About UsMomentum Resource Solutions is a leading provider of claims processing services, dedicated to delivering high-quality solutions to our clients. We are committed to excellence and strive to create a workplace that fosters collaboration and innovation.We offer competitive salaries, comprehensive benefits, and opportunities for growth and development....

Job Overview:Momentum Resource Solutions is seeking an experienced Director of Claims Quality to lead our claims operations team. This role is a great opportunity for a motivated individual to drive excellence in claims quality and process improvement.

Job DescriptionMomentum Resource Solutions is seeking an experienced Claims Quality Director to lead our Claims department. The successful candidate will be responsible for driving quality assurance and performance oversight programs, ensuring payment accuracy, and promoting a culture of continuous improvement.The ideal candidate will have a strong...

Athari: Unlocking Medical Expense SavingsWe are seeking a skilled Claims Optimization Specialist to join our team at Athari. In this role, you will play a crucial part in developing and implementing strategies to recover, eliminate, and prevent unnecessary medical-expense spending.About the Role:Develop a comprehensive strategic roadmap to recover,...

Key ResponsibilitiesDesign, develop, and deploy scalable cloud-based claims systems to process 10+ million claims per day.Collaborate with top-notch engineers and the Chief Architect to identify and mitigate technical risks.Leverage machine learning to detect fraud, waste, and abuse in claims, improving system integrity and enabling cost-saving...

Welcome to Global Channel ManagementWe are seeking an experienced Cash Claims Processor to join our team. This role requires a strong background in data entry and processing transactions accurately and efficiently. The successful candidate will have excellent attention to detail and be able to maintain high productivity levels while meeting our strict...

Job Description:Sedgwick is a global leader in technology-enabled risk, benefits, and integrated business solutions. Our mission is to help organizations protect their employees, customers, and assets from various risks. We are seeking a highly skilled Workers Compensation Claims Adjuster to join our team.About the Role:The ideal candidate will have a strong...

About UsRitual Dental is a pioneering dental practice harnessing cutting-edge technologies to transform the oral health landscape. Our commitment to leveraging technology enables our skilled team to focus on providing personalized coaching and care to our patients.We're driven by a passion for creating innovative solutions that empower patients to make...

About Us The Mount Sinai Health System is a leading academic medical center that advances health for all people, everywhere. We take on the most complex health care challenges of our time and leverage innovative approaches to improve patient outcomes. Our team of experts provides comprehensive health care solutions from birth through geriatrics. We are...

Oscar Health's Claims Resolution Professional plays a critical role in ensuring that our company remains compliant with all relevant laws and regulations. As a member of our Payment Integrity team, you will be responsible for analyzing claims data to identify potential overpayments, communicating with healthcare providers to recover these overpayments, and...

Job Description:The Director of Claims Quality will oversee the creation, delivery, and facilitation of a metrics-driven claims quality assurance and performance oversight program. This includes defining frameworks and benchmarks, calibrating and reporting on program progress, and promoting a culture of continuous improvement. Additionally, this role...

Job SummaryWe are seeking a highly skilled Medical Claims Investigator to join our team at NYC Health + Hospitals. As a key member of the Revenue Cycle Services team, you will play a critical role in ensuring the accuracy and timeliness of medical claims processing.About UsNYC Health + Hospitals is one of the largest public health systems in the United...