RCM Insurance Claims Manager

Responsibilities

• Lead and manage the claims process for diagnostic laboratory services from submission through final resolution
• Oversee the review and resolution of denied, pending, and aging claims
• Ensure claims compliance with payer requirements, billing guidelines, and regulatory standards
• Partner with internal teams and external billing vendors to resolve complex claim issues
• Monitor claims inventory, accounts receivable performance, and operational metrics
• Lead, coach, and develop the Claims team to drive productivity and quality
• Analyze claims and denial trends to implement process improvements
• Prepare regular reports on claims activities and reimbursement trends for leadership
• Coordinate system implementations and upgrades related to billing operations
• Develop and maintain claims-related policies, procedures, and training materials

Requirements

• Bachelo...