Remote Healthcare Claims Project Manager | WFH

Job Overview

We are seeking a highly skilled and accomplished Healthcare Claims Project Manager to become an integral part of our innovative consulting team. In this pivotal role, you will report directly to the Program Director and have the opportunity to spearhead significant projects while fostering your professional growth within the industry.

Key Responsibilities

• Lead and oversee healthcare projects focused on claims processing and payment, ensuring successful project delivery.
• Analyze Statements of Work (SOWs) and Requests for Proposals (RFPs) to identify opportunities and formulate comprehensive implementation strategies.
• Manage project execution, collaborating with subcontractors to meet compliance with client specifications.
• Utilize advanced Excel functions to manipulate and analyze medical claims data, identifying trends and insights through techniques such as pivot tables.
• Effectively manage project budgets, optimizing resources while maintaining an understanding of the overall budget creation framework.
• Develop and execute strategies to improve the efficiency and accuracy of claims processing.
• Engage with clients to gain insights into their needs, delivering tailored solutions.
• Analyze claims data to pinpoint trends, issues, and key focal points for the project.
• Ensure adherence to all relevant regulations and standards in the healthcare sector.
• Work in conjunction with IT teams to manage file transfers and uphold data integrity.
• Provide training and support to clients and team members regarding claims processing and payment systems.
• Prepare comprehensive reports and presentations for clients and stakeholders.
• Monitor project progress, making necessary adjustments to meet deadlines and objectives.
  
  

Required Skills

• Extensive experience in healthcare claims processing and payment.
• Familiarity with multiple claims payment systems that facilitate end-to-end claims processing.
• Proven project management skills with a track record of managing complex healthcare initiatives.
• Strong analytical capabilities and independent problem-solving skills, particularly in a remote working environment.
• Exceptional communication and interpersonal skills, thriving in a collaborative team setting.
• Proficiency in relevant software and tools, including Excel, MS Planner, MS Project, EncoderPro, Codify, SharePoint, and Salesforce.
  
  

Qualifications

• A minimum of 5 years of experience in healthcare claims processing and payment.
• At least 3 years of experience leading and managing programs involving multiple full-time resources, with a total budget exceeding $4M.
• Strong understanding of various claims processing files and file transfer methodologies.
• Experience in a healthcare consulting environment focused on government programs is preferred.
• Relevant certifications in project management, such as PMP or PRINCE2, are highly desirable.
  
  

Career Growth Opportunities

This position offers significant career advancement potential within the healthcare consulting field, with numerous opportunities for professional development and skill enhancement.

Company Culture And Values

Our organization promotes a culture of collaboration, innovation, and commitment to delivering exceptional healthcare solutions, fostering a supportive working environment that encourages professional growth and shared success.

Employment Type: Full-Time