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Insurance
The Claims QA Auditor Lead oversees the daily operations of the Claims Quality Team, ensuring the quality review program is effective and reporting metrics accurately. They manage audits, mentor team members, and identify quality improvement opportunities.
Top Skills:
Claim Adjudication SystemsMS Office
Insurance
The VP Product Management leads product strategy and development, oversees the entire product lifecycle, and collaborates cross-functionally to ensure alignment and meet business goals.
Top Skills:
Agile MethodologiesProduct Management Tools
Insurance
The Senior Claims Data Analyst enhances claims operations through advanced analytics, develops reports and dashboards, identifies process improvements, and ensures data integrity to drive strategic decisions.
Top Skills:
AWSPower BIPythonRSnowflakeSQLTableau
Insurance
The Product Manager at Centivo will develop product vision, collaborate across teams, and drive market growth initiatives, ensuring alignment with company goals.
Top Skills:
ConfluenceJIRAProduct Analytics Platforms
Insurance
The Configuration Specialist Pricing maintains provider contract configurations, ensuring compliance with standards, and collaborates with various teams for accurate claims processing.
Top Skills:
Healthedge SourceHealthrulespayerMS Office
Insurance
Lead and supervise end-to-end stop loss administration for self-funded clients, managing claim identification, carrier submissions, reporting, UAT for system changes, cross-functional coordination, staff training, and process improvements to ensure timely reimbursement and contractual compliance.
Top Skills:
Excel,Powerpoint,Word,El Dorado,Javelina,Health Rules Payer (Hrp),Ringmaster Smart-Linq
Insurance
Own end-to-end stop loss policy administration for self-funded clients. Liaise with carriers, TPAs, brokers, and internal teams to manage specific and aggregate claims, analyze policies, deliver and automate monthly reports, generate financial data, identify high-cost claimants, and support renewals and implementation.
Top Skills:
Excel,Powerpoint,Word,El Dorado,Javelina,Health Rules Payer (Hrp),Ringmaster Smart-Linq
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