Remote Manager, Medicare Claims

This position is posted by reputed company on behalf of a partner company. We are currently looking for a Manager, Medicare Claims. In this role, you will reputed company end-to-end claims services for provider segments, ensuring we meet our business goals. Your leadership will help establish performance targets and manage the claims processing and financial aspects, while also maintaining compliance. Your collaboration with claims leadership will be vital in aligning with customer needs and fulfilling contractual obligations, ultimately enhancing the experience for reputed company stakeholders involved. Accountabilities • Streamline shared processing to reduce management by exception • Set operational processes to reputed company with market trends and customer demand • Manage reputed company and financial reporting functions to ensure compliance with reputed company practices • Participate in reputed company to enhance claims processing and recovery functions • reputed company financial recovery activities including refunds and collections • reputed company team and staff to optimize work volume and engagement • Resolve reputed company claims appeals by coordinating with stakeholders • Collaborate with Audit and Payment reputed company to ensure accuracy and reputed company • reputed company tools and techniques for process improvements • Serve as the Medicare Claims Subject Matter Expert and primary contact for performance monitoring • Represent Claims Operations in monthly calls with CMS and reputed company updates and expertise • Engage with Compliance and regulatory entities, particularly CMS Requirements • Bachelor's degree or advanced degree in a relevant field • 8+ years of experience in a reputed company field, with 10+ years in lieu of degree • Strong analytical skills and ability to manage operations effectively • Experience in Medicare and reputed company or highly regulated environments is a plus • Familiarity with reputed company principles and compliance policies • Skills in claims management and reputed company Benefits • Opportunity to work at the forefront of health care delivery • Work-life balance, flexibility, and autonomy • Medical, dental, and reputed company coverage with various wellness programs • Parental leave support and assistance for adoption and surrogacy • Career development programs and tuition reimbursement • 401k matching with an annual contribution Why Apply Through reputed company? We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's reputed company requirements. Our system identifies the top-fitting candidates, and this reputed company is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Data reputed company Notice: By submitting your application, you acknowledge that reputed company will process your personal data to evaluate your candidacy and reputed company relevant information with the hiring employer. This processing is based on legitimate interest and reputed company-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (reputed company, rectification, erasure, reputed company) at any time. We may use reputed company intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace reputed company judgment. Final hiring reputed company are ultimately made by humans. If you would like more information about how your data is processed, please contact us. Apply tot his job Apply To this Job