The Claims Reconciliation Manager at Veuu is responsible for analyzing, reviewing, and resolving complex healthcare claims, specifically targeting issues within the dead letter claim queue. This role requires expertise in claims processing, reimbursement methodologies, medical coding (ICD-10, CPT, PCS, HCPCS), and healthcare regulations including CMS guidelines and HIPAA.
Key duties include managing daily reconciliations and reporting, vendor management, developing claim review strategies to minimize revenue loss, generating reports with insights, collaborating across operations, compliance, providers, and payers to resolve discrepancies, training teams on best practices, and recommending process and technology improvements to enhance claim resolution effectiveness.
Candidates should have a bachelor's degree in healthcare administration, finance, business or related field (or equivalent experience), extensive experience in claims reconciliation and healthcare revenue cycle, strong analytical and leadership skills, and proficiency with claims management systems, EHR platforms, and reporting tools. Preferred qualifications include certifications such as CPC, CCS, CPMA, or CHFP, as well as skills in data visualization tools like SQL, Power BI, or Tableau.
This is a full-time role based in Tampa, FL.
- Bachelor's degree in healthcare administration, finance, business, or related field (or equivalent experience)
- Extensive experience in claims reconciliation, medical billing, coding, or healthcare revenue cycle operations
- Expertise in medical coding standards (ICD-10, CPT, PCS, HCPCS) and reimbursement methodologies
- Familiarity with CMS guidelines, HIPAA, payer policies, and healthcare regulations
- Strong analytical, problem-solving, and process optimization skills
- Proficiency with claims management systems, EHR platforms, and reporting tools
- Excellent communication and leadership abilities
- Preferred: Certifications such as CPC, CCS, CPMA, or CHFP
- Preferred: Proficiency with SQL, Power BI, Tableau or similar data visualization tools
- Knowledge of value-based payments, DRG/APC reimbursement, risk-adjusted payment models, and payer contract negotiations
Veuu is an Equal Opportunity and Affirmative Action Employer that supports equality, professional development, challenging careers, and offers competitive compensation. Employment is merit-based without discrimination. Applicants must be legally authorized to work in the U.S., and employment offers may require drug screening.
Location
Tampa, Florida, US
Employment Type
Full-time
Experience Level
Manager
Remote work allowed
No
Posted
1 year ago