Director, Claims

Altais

Remote
Base: $129,000 - $154,800pyr; bonus/equity: eligib...
Claims processing and appeals
Operational process design and optimization
Performance management and improvement
This position is responsible for providing strategic leadership, as well as developing and controlling all day-to-day operations, overseeing claims processing, claims appeals, and claims recovery

Job Summary

  • This position is responsible for providing strategic leadership, as well as developing and controlling all day-to-day operations, overseeing claims processing, claims appeals, and claims recovery.
  • The role requires close collaboration with IT, vendors, and cross-functional business teams to drive continuous operational and technical improvements and lead automation initiatives.
  • The company offers excellent medical, vision, and dental coverage, a 401k savings plan with a company match, flexible time off, and eligibility for an annual bonus program.

Matching Summary

This position is responsible for providing strategic leadership, as well as developing and controlling all day-to-day operations, overseeing claims processing, claims appeals, and claims recovery.

Salary

Base: $129,000 - $154,800/yr; Bonus/Equity: Eligible for annual bonus program; Benefits: Medical, vision, dental, 401k with match, flexible time off, 9 holidays

Skills & Requirements

Must-have

  • claims processing and appeals
  • operational process design and optimization
  • performance management and improvement
  • vendor relationship management
  • automation initiatives
  • CMS and state regulatory compliance

Nice-to-have

  • collaborative and purpose-driven team
  • integrity and adaptability
  • physician and patient experience focus

Key Requirements

  • 10+ years related experience
  • 7+ years in a leadership role
  • 5+ years of experience with BPO/BPaaS solutions
  • Experience scaling operational teams
  • Experience with claims transformation, automation, or process improvement
  • Advanced knowledge of ICD-10, CPT, and HCPCS
  • Thorough understanding of Commercial/Medicare Advantage claims rules
  • Experience developing and managing department budgets
  • Bachelor's Degree or equivalent experience

Work Rights

Not specified

Tailored Resume

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