Newton-Wellesley Hospital(NWH)
Medicare Supervisor Claims Reviewer
What's your preference?
Job Description
- Req#: RQ4045671
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $113,453.60 annually
- Comprehensive benefits package and bonuses based on performance
- Opportunity for career advancement and professional growth within the organization
- Flexible remote work option available from most U.S. states
- Supportive and collaborative work environment focused on continuous learning
- Chance to make a significant impact on healthcare claims processing
What to Expect (Job Responsibilities):
- Supervise and manage a team of claims reviewers to ensure accurate and timely healthcare claims processing
- Oversee claims review and analysis for compliance with healthcare regulations and payer requirements
- Resolve escalated or complex claims issues, ensuring appropriate adjudication and dispute resolution
- Monitor team performance, provide feedback, and conduct regular evaluations to support professional growth
- Collaborate with billing, coding, and compliance teams to ensure adherence to regulatory and payer standards
What is Required (Qualifications):
- Bachelor's Degree required (experience can be substituted in lieu of degree)
- At least 3-5 years of experience in healthcare claims review or processing
- Minimum of 1-2 years of experience in a senior or leadership role
- Strong knowledge of healthcare claims processes, coding (CPT, ICD-10), and payer regulations
- Proficiency in claims processing software and healthcare management systems
How to Stand Out (Preferred Qualifications):
- Medicare Advantage claims experience is highly preferred
- Experience with QNXT is highly preferred
- Excellent leadership, communication, and problem-solving skills
- Strong attention to detail with the ability to manage multiple tasks and priorities
#HealthcareServices #ClaimsProcessing #RemoteWork #CareerGrowth #LeadershipOpportunityAbout the company
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.