Healthcare Claims Resolution & Compliance Manager at Alteva RCM
United States
$100k - $150k
<div class="content-intro"><p><strong>About Us</strong></p> <p>At Alteva RCM, we're dedicated to helping healthcare providers thrive through expert revenue cycle management, strategic insight, and innovative solutions. We're always looking for passionate, driven professionals who want to make a meaningful impact, grow their careers, and be part of a collaborative team committed to excellence.</p></div><p><strong><span data-contrast="none"><span data-ccp-parastyle="heading 2">Role Overview</span></span></strong><span data-ccp-props="{"335559738":200}"> </span></p> <p><span data-contrast="auto">We are seeking an experienced manager to lead our growing Claims Resolution function. This role requires strong management skills, familiarity with healthcare regulatory processes, and the ability to navigate the interaction between multiple layers of regulatory requirements as they relate to healthcare reimbursement, dispute resolution, and revenue cycle operations.</span><span data-ccp-props="{"335559739":200}"> </span></p> <p><span data-contrast="auto">The ideal candidate can research, interpret, and apply jurisdiction-specific requirements in a fast-moving environment, and translate complex regulatory information into clear, practical guidance for operational teams.</span><span data-ccp-props="{"335559739":200}"> </span></p> <p><span data-contrast="auto">The Manager will lead team members and team leads, maintain workflow efficiency, ensure deadlines and quality standards are met, and help the department scale in an organized, effective manner.</span><span data-ccp-props="{"335559739":200}"> </span></p> <p><strong><span data-contrast="none"><span data-ccp-parastyle="heading 2">Key Responsibilities</span></span></strong><span data-ccp-props="{}"> </span></p> <ul> <li><span data-contrast="auto">Manage daily operations of the Claims Resolution function, ensuring work is completed accurately, efficiently, and on schedule.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Oversee team leads and team members, providing direction, accountability, coaching, and support.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Develop and maintain workflows, reporting structures, and internal processes to support department growth.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Monitor team performance and identify opportunities to improve productivity, quality, consistency, and regulatory compliance.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Maintain a strong working knowledge of relevant healthcare regulations, rules, and procedural requirements across multiple jurisdictions.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Understand the distinctions, overlap, and potential conflicts between different regulatory frameworks as they relate to healthcare claims and reimbursement disputes.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Evaluate which procedural framework applies to a given claim or dispute, and ensure operational procedures reflect the correct process.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Research jurisdiction-specific requirements as needed and translate findings into operational guidance, workflows, and training materials.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Monitor relevant regulatory developments and assess their operational impact.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Coordinate with senior leadership on department performance, staffing, workflow challenges, and strategic priorities.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Partner with legal, compliance, and revenue cycle teams on complex or overlapping regulatory questions.</span><span data-ccp-props="{"335559739":120}"> </span></li> </ul> <p><strong><span data-contrast="none"><span data-ccp-parastyle="heading 2">Requirements</span></span></strong><span data-ccp-props="{"335559738":200}"> </span></p> <ul> <li><span data-contrast="auto">Proven managerial experience, preferably overseeing multiple team members or team leads.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Ability to manage a fast-paced, high-volume department with strong attention to deadlines and detail.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Strong research and analytical skills; ability to interpret and apply regulations and procedural requirements.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Familiarity with regulatory frameworks affecting healthcare reimbursement, claims processing, and dispute resolution.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Ability to translate regulatory concepts into clear operational procedures.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Excellent communication, leadership, and organizational skills.</span><span data-ccp-props="{"335559739":120}"> </span></li> <li><span data-contrast="auto">Experience in dispute resolution, legal operations, healthcare compliance, health insurance, revenue cycle management, medical billing, or another regulated healthcare environment strongly preferred.</span><span data-ccp-props="{"335559739":120}"> </span></li> </ul> <p><strong><span data-contrast="none"><span data-ccp-parastyle="heading 2">Shift Requirements</span></span></strong><span data-ccp-props="{"335559738":200}"> </span></p> <p><span data-contrast="auto">Must be able to work a flexible schedule to coordinate with distributed team members across time zones, including some overlap with international team members and availability for leadership check-ins later in the workday, Eastern Time.</span></p><div class="content-pay-transparency"><div class="pay-input"><div class="title">Pay Range</div><div class="pay-range"><span>$100,000</span><span class="divider">—</span><span>$150,000 USD</span></div></div></div><div class="content-conclusion"><p> </p> <p><strong>Benefits</strong></p> <p>Alteva RCM offers our employees a comprehensive benefits package, including health, dental, vision, employee assistance plan, paid family leave, short-term disability and life insurance. We also provide a 401(k) plan with employer match, flexible spending accounts, employee discount program and an employee referral program.</p> <p> </p></div>
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