Director of Claims Payment & Payment Integrity Operations - Remote

Overview

The Director of Claims Payment & Payment Integrity Operations at Gravie will lead the team responsible for managing claims payment processes and ensuring compliance with regulatory standards.

In Short

• Lead claims payment and payment integrity operations.
• Develop efficient processes for claims payments.
• Manage vendor relationships and ensure performance standards.
• Analyze data for process improvement opportunities.
• Implement risk management strategies to protect from fraud.
• Mentor and develop a team culture of accountability.
• Ensure adherence to regulatory and contractual requirements.
• Collaborate with various teams to resolve complex issues.
• Make strategic decisions based on data analysis.
• Participate in annual bonus and stock option programs.

Requirements

• Bachelor's degree or equivalent experience.
• 8+ years of experience in healthcare claims and payments.
• 3+ years of team management experience.
• Understanding of regulatory requirements in healthcare.
• Knowledge of health insurance payment integrity best practices.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Proven leadership and management skills.
• Ability to collaborate effectively.
• Experience with data-driven decision making.

Benefits

• Comprehensive health and wellness benefits.
• Flexible PTO and paid parental leave.
• 401k program with company matching.
• Education reimbursement.
• Cell phone reimbursement and transportation perks.
• Paid holidays and paw-ternity leave.
• Participation in annual bonus program.
• Stock options as part of compensation.
• Supportive work culture focused on growth.
• Opportunities for career advancement.