Claims Operations Associate Director - Remote

Overview

The Claims Operations Associate Director is a subject matter expert responsible for providing regulatory operational support for MCIC’s internal and external customers, ensuring compliance with internal controls, Medicare, and other mandated regulatory reporting.

In Short

• 100% Remote position available in various U.S. states.
• Provide regulatory-focused operational support and training.
• Exhibit leadership influence to gain consensus among stakeholders.
• Identify and implement opportunities for process improvement.
• Deliver Medicare reporting compliance through accurate data capture.
• Partner with Data Analytics for mandated reporting oversight.
• Responsible for the efficient processing of new claims.
• Contribute to the development of documentation for regulatory procedures.
• Stay updated on regulatory changes impacting the Claims function.
• Participate in special projects related to data quality and governance.

Requirements

• Experience in claims operations and regulatory compliance.
• Strong leadership and stakeholder management skills.
• Ability to analyze data and identify process improvements.
• Knowledge of healthcare insurance regulations.
• Excellent communication and training skills.
• Experience working with data analytics teams.
• Ability to manage multiple projects and deadlines.
• Detail-oriented with a focus on compliance.
• Experience in a remote work environment.
• Familiarity with Medicare reporting requirements.

Benefits

• Comprehensive medical and dental insurance.
• Retirement savings plan with employer match.
• Flexible work hours and remote work options.
• Professional development opportunities.
• Supportive work culture focused on employee well-being.
• Paid time off and holidays.
• Opportunities for career advancement.
• Wellness programs and resources.
• Employee assistance programs.
• Engagement in meaningful work that impacts healthcare.