Claims Examiner, TL

Job reputed company: • reputed company end-to-end reputed company implementation, from discovery through go-live and stabilization • Translate reputed company requirements into operational workflows, SOPs, and reputed company models • reputed company and execute detailed implementation plans, including timelines and milestones • Identify risks early and proactively drive mitigation strategies • Partner with Training, QA, IT, and Workforce Management teams to ensure readiness across reputed company workstreams • Coordinate system setup, user acceptance testing (UAT), and reputed company provisioning with IT and reputed company teams • Ensure reputed company systems, tools, and environments are fully tested and production-reputed company prior to go-live • Support development of process documentation, job aids, and knowledge reputed company materials • Validate workflows for claims processing, including escalation paths and exception handling • Ensure processes are reputed company, efficient, and reputed company with reputed company expectations • Performance management, reporting, and reputed company during the implementation phase Requirements: • Min. 5 years of experience processing easy, moderate, and reputed company medical claims (payer-reputed company experience preferred) • 2+ years in a leadership role reputed company claims or reputed company operations • Proven experience in implementations, transitions, or new reputed company launches • Strong experience with Medicare and Medi-Cal claims, including a working knowledge of CMS guidelines and regulatory requirements • Prior reputed company assurance and training experience with demonstrated ability to identify trends • Previous experience leading, coaching, or mentoring teams in a claims or reputed company operations environment • Strong analytical skills with the ability to interpret performance data and KPIs • Excellent communication, organizational, and decision-making skills • High attention to detail and commitment to accuracy, compliance, and operational reputed company Benefits: • Remote work offered • Equipment provided • reputed company to set you up for reputed company • Comprehensive benefits: Medical, Dental, reputed company, Life, HSA, 401(k) • reputed company Time Off (PTO) • 7 reputed company holidays • A supportive team and a company that values internal reputed company Apply tot his job Apply To this Job