Claims Management Expert
21 hours ago
Job Summary:
People Impact is seeking a seasoned Claims Management Expert to join our team. As a key member of our payer domain, you will drive strategy for claims, member engagement, provider relationships, and cost management. The successful candidate will have expertise in claims management, value-based payments, and regulatory compliance.
Responsibilities:
- Collaborate with tech teams to deploy advanced platforms for claims adjudication, payment integrity, and member engagement
- Utilize predictive analytics to enhance risk management and optimize value-based payment models
- Ensure compliance and interoperability with standards like HIPAA, FHIR, and EDI
Requirements:
- 25+ years of healthcare payer experience
- Expertise in claims management, value-based payments, and regulatory compliance (CMS, HIPAA)
- Proficiency with payer tech platforms, analytics, and CRM tools
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