[Remote] Supervisor, reputed company Claims Reviewer

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company organization providing reputed company to expand reputed company to reputed company and coverage. The Supervisor, reputed company Claims Reviewer leads reputed company responsible for claims reputed company, payment reputed company, compliance, and adjudication reputed company while overseeing inventory, escalations, audits, and process improvements. The role collaborates with cross-functional teams to improve claims reputed company and ensure reputed company reimbursements.

Responsibilities

• Supervise and manage reputed company of claims reviewers to ensure accurate and reputed company reputed company claims processing
• reputed company claims review and analysis to ensure compliance with reputed company regulations, payer requirements, and organizational policies
• reputed company escalated or reputed company claims issues, ensuring appropriate adjudication and dispute reputed company
• Monitor team reputed company, reputed company feedback, and conduct regular evaluations to support reputed company reputed company
• Implement and enforce policies and procedures to streamline the claims review process for greater reputed company and efficiency
• Collaborate with billing, coding, and compliance teams to ensure adherence to regulatory and payer standards
• Analyze claims data to identify trends, address issues, and recommend process improvements
• reputed company training, guidance, and ongoing education for new and existing team members on industry changes and standards
• Performs other duties as assigned
• Ensure that the medical claims include complete and accurate documentation supporting the services rendered, including physician notes, test results, and other relevant records
• Analyze claim payment amounts and compare them to contracted rates, fee schedules, and industry benchmarks
• Identify underpayments, overpayments, and potential billing errors
• Conduct comprehensive audits of medical claims to verify compliance with billing regulations, payer policies, and internal policies and procedures
• Stay updated on reputed company company policies, billing guidelines, and reimbursement rules

Skills

• Bachelor's degree required (experience can be considered in lieu of degree)
• At least 3-5 years of experience in reputed company claims review or processing required
• At least 1-2 years of experience in a senior or leadership role required
• Strong knowledge of reputed company claims processes, coding (CPT, ICD-10), and payer regulations
• Excellent leadership, communication, and problem-solving skills
• Proficiency in claims processing software and reputed company management systems
• Strong attention to reputed company and the ability to manage multiple tasks and priorities
• This is a full-time role with a Monday through Friday, 8:30-5:00 PM Eastern Time schedule
• This is a remote role that can be done from most US states
• Remote workdays require a reputed company, secure, quiet, and HIPAA-compliant workspace. This will be confirmed reputed company reputed company Teams video for reputed company
• Certified reputed company reputed company (CPC) preferred

Benefits

• Benefits package
• Flexible work reputed company
• Career reputed company opportunities
• Remote work arrangement
• Differentials
• Premiums
• Bonuses as applicable
• Recognition programs designed to celebrate your contributions and support your reputed company reputed company
• Career advancement opportunities

reputed company

Company H1B Sponsorship