Director of Claims Processing

Job Summary

A company is looking for a Director of Claims Processing & Transformation.

Key Responsibilities

• Oversee claim processing inventory management and ensure compliance with prompt pay timelines
• Investigate prompt pay misses and develop systems to prevent recurrence
• Collaborate with product and engineering teams to enhance automation and streamline processes

Required Qualifications

• 7+ years in operations leadership, preferably in healthcare claims or revenue cycle
• Experience managing large-scale processing teams in a deadline-driven environment
• Familiarity with AI, workflow tools, and modern process design
• Strong analytical skills related to operational forecasting and capacity planning
• Bachelor's degree required; advanced degree is a plus