Job Summary

• Own end-to-end problem solving for claims operations: improve auto-adjudication, reduce rework/denials, and modernize integrations.
• Partner with business, data, and engineering to deliver measurable gains in first-pass adjudication, throughput, and cost-per-claim.
• Apply GenAI/NLP for denial reasoning extraction and claim note summarization with HITL.

Matching Summary

Skills & Requirements

Key Requirements

• 6-10 years US healthcare consulting/solution delivery
• Hands-on claims adjudication, Membership/prior auth, care management
• Working knowledge of HIPAA Privacy/Security
• Techno-functional ability to translate business needs
• Practical GenAI solutioning and classical analytics experience
• Consulting, proposal/RFP experience, stakeholder management
• Executive storytelling and workshop facilitation

Work Rights