Senior Manager, Medical & Clinical Claims Policy (Remote)
Brighton Health Plan Solutions
- Remote job
Brighton Health Plan Solutions is seeking a Senior Manager of Medical and Clinical Claim Policy and Configuration to oversee policy content and system configurations. This role collaborates with Medical Management, Network Management, Claims, Operations, IT, Sales and Legal to ensure effective policy implementations. This remote position focuses on developing and maintaining medical/claims policies, CODING rules, and policy publication while ensuring regulatory alignment and operational #J-18808-Ljbffr Brighton Health Plan Solutions
- ...About The Role The Senior Manager of Medical and Clinical Claim Policy and Configuration is a senior level decision maker responsible for the content and... ...Sales and Account Management, and Legal. *This is a remote role. Primary Responsibilities Review, update,...Remote workSeniorPolicyMedicalClaimsLocal areaFlexible hours
- ...Job Title: Senior Manager, Clinical & Coding Location: Remote Employment Type: Full‑Time Position... ...Direct audit intake, medical record review, clinical... ...guidelines, payer policies, and internal compliance... ...recovery for inpatient claims. Establish and maintain...Remote workSeniorPolicyMedicalClaimsPermanent employmentFull time
$129.3k - $172.3k
...an in-house opportunity?The Senior Claims Counsel position with First American... ...to difficult problems, manage their own caseload, oversee outside... ...loss under the title policy, assess defenses for the insured... ...benefits package including medical, dental, vision, 401k, PTO/paid...Remote workSeniorPolicyMedicalClaimsFull time- Selective Insurance is seeking a Claims Litigation Specialist for a remote position. Investigate,... ...and contractual issues. Manage defense counsel to ensure... ...compliance with company policies from start to finish. You... ...reports, coordinate medical examinations when needed,...Remote jobSeniorPolicyMedicalClaims
$200k - $235k
...LITIGATORS! APPLY NOW!SENIOR ASSOCIATE ATTORNEY - SPECIALTY... ...(Los Angeles, Irvine)REMOTE (everyday besides... ..., errors and omissions claims involving attorneys, agents... ...policies and draft detailed coverage... ...EligibilityComprehensive Benefits Package: Medical, dental, vision,...Remote workSeniorPolicyMedicalClaimsWork at officeFlexible hours$200k - $235k
...LITIGATORS! APPLY NOW!SENIOR ASSOCIATE ATTORNEY - SPECIALTY... ...(Los Angeles, Irvine)REMOTE (everyday besides... ..., errors and omissions claims involving attorneys, agents... ...policies and draft detailed coverage... ...EligibilityComprehensive Benefits Package: Medical, dental, vision,...Remote workSeniorPolicyMedicalClaimsWork at officeFlexible hours$132.4k - $198.6k
...well beyond coverages and policies. Working here means... ...partnering closely with Claims and directly advising insureds. This Remote position is an ideal fit... ...tools: Leverage case management and approved technology... ...rewards you can feel: Medical, dental, vision, life;...Remote workSeniorPolicyMedicalClaimsTemporary workWork at officeLocal areaWork from home$110.5k - $150k
...partner company, who manages all applications... ...Development Senior Manager – Clinical & Facility Specialist... ...the healthcare claims ecosystem. You will... ..., healthcare policy expertise, coding... ...society guidelines, medical policies, and... ...) program . ~ Remote work within the...Remote workSeniorPolicyMedicalClaimsFull timeLocal area- ...of 4 days in office, 1 remote day per week. Also... ...Position Summary The Senior Claims Consultant serves as a... ...role is responsible for managing complex claims, overseeing... ...support of claims and policy management. Contribute... ...-paid benefits (medical, dental, vision, health...Remote workSeniorPolicyMedicalClaimsFull timeWork at office1 day per week
$125k - $140k
...,000,Category: Claims & UnderwritingCompany... ...is a fully remote position in the... ...is a senior position for a... ...LTC claim and medical impairment knowledge... ...strong relationship management skills, and the... ...requiring advanced clinical, contractual,... ...guidelines, policy provisions, treaty...Remote workSeniorPolicyMedicalClaimsTemporary workWork experience placementShift work- Centene Corporation is seeking a senior leader to provide strategic direction for teams performing advanced medical claim reviews. You will drive accuracy, regulatory compliance... ...leveraging ICD-10, CPT/HCPCS coding, and clinical guidelines. The role leads standardization...Remote jobSeniorMedicalClaims
$138.8k - $198.3k
...flexible vacation policy and educational... ...is seeking a Senior Principal,... ...lead Medicaid claims-related product... ...modern product management practices, and... ...provider, benefits, clinical, and finance. The... ...is 100% remote with the opportunity... ...childbirth, or related medical condition), age...Remote workSeniorPolicyMedicalClaimsFull timeFlexible hours$280.84k - $393.18k
...Health Services, the Senior Medical Director Policy & Outcomes (Sr.... ...Medical Policies and clinical leadership around member... ...including quality management, grievance and appeals... ...relations, and claims.Serve as a liaison with... ...schedule. (Mon & Fri - remote, Tues - Thurs onsite...Remote workSeniorPolicyMedicalClaimsTemporary workLocal area$98.4k - $141.6k
...Chubb is seeking a Senior Claim Examiner to handle PEO... ...appropriate direction from the manager, investigates and... ...guidelines. This non-remote position is based in our... ...Liability insurance policies. Establish, document... ...physical disability, medical condition, genetic information...Remote workSeniorPolicyMedicalClaimsWork experience placementWork at officeLocal area$80k - $120k
...Job Title: Senior Payroll Specialist Location (city... ...is eligible for medical, dental, vision, and 40... ...segments compliance for remote workforce across multiple... ...broker to support insurance claims and general... ...explanation of benefits, policies and systems, prepare new...Remote workSeniorPolicyMedicalClaimsLocal areaRelocation- ...technical solutions Manage and prioritize multiple... ...of benefits including medical, dental, and vision coverage... ...generous paid time off policy ensures you have time... ...are provided for remote workspace. ABOUT... ...over 200,000 insurance claims annually for leading national...Remote workSeniorPolicyMedicalClaimsTemporary work
$80k - $125k
...innovative and growing Claims team where you'll... ..., qualified remote candidates will also... ...Hartford, CTThe Role:The Senior Claims Examiner... ...with company policies and applicable regulatory... ...and notify the manager if upward... ...dental and FSA plans (medical, limited purpose,...Remote workSeniorPolicyMedicalClaimsTemporary workWork at office2 days per week$103.45k - $197.73k
...USAA roles may offer remote or hybrid... ...consistent with applicable policy and business needs... ...OpportunityAs a Senior Data Product Owner... ...Pricing and Claims team, you will be... ...Clarity to create and manage product features,... ...include comprehensive medical, dental and vision...Remote workSeniorPolicyMedicalClaimsFull timeH1bWork at officeHome officeRelocation packageFlexible hours$44.45k - $69.34k
...consistent with department policies and procedures.... .... Coordinates clinical documentation... ...improvements for financial management of each billing... ...Insurance claim adjudication knowledge... ...posting Medical billing and claims... ...compliance requirements Remote Monday-Friday. 8am...Remote workSeniorPolicyMedicalClaimsHourly payContract workWork at officeMonday to Friday$63.59k - $121.53k
.... USAA roles may offer remote or hybrid flexibility for... ...with applicable policy and business needs.The... ...complex bodily injury claims to include confirming coverage... ...you'll do:Identifies and manages existing and emerging... ...knowledge of human anatomy and medical terminology associated...Remote workSeniorPolicyMedicalClaimsContract workH1bWork at officeRelocation package3 days per week- Position SummaryThe Operations Senior Manager, Individual Dental Operations... ...planning processes.Claims & Enterprise Operations OversightProvide... ...pregnancy) or related medical conditions including but not... ...Cigna Group has a tobacco-free policy and reserves the right not to...Remote workSeniorPolicyMedicalClaimsFull timeLocal areaWork from home
$75k - $85k
Employee Benefits Senior Account Manager We are seeking an Employee... ...to marketing, claims, and administration;... ...: Ensure accuracy of policy data within agency management... ...up to two days remote, alternating 5‑day &... ...benefits, including Medical, Dental, Vision, and...Remote workSeniorPolicyMedicalClaimsFull timeWork experience placementFlexible hours- ...Oklahoma seeks an Experienced Professional Medical Coder to perform complex professional... ...ensuring accurate E/M levels and applying payer policies. You will help streamline denial... ..., and process improvement, with flexible remote/hybrid options and a comprehensive benefits...Remote jobSeniorPolicyMedicalClaimsFlexible hours
- ...Space LLC is seeking an AR Manager to lead complete and... ...of designated claims, reviewing daily physician... ...denial management and policy updates, and coordinate... ...role requires 5+ years in medical billing, strong Excel and... ...and the ability to work remotely with a quiet, #J-18808...Remote jobSeniorPolicyMedicalClaims
$118.8k - $198.6k
...beyond coverages and policies. Working here... ...a Staff Attorney/Senior Staff Attorney in... ...partnering closely with claims professionals to... ...role is primarily remote in the state of California... ...and outcomes: Manage a WC caseload with... ...you can feel: Medical, dental, vision, life...Remote workSeniorPolicyMedicalClaimsFull timeTemporary workWork from home$80.1k - $107k
...Claims Field Senior Property Adjuster Job Summary This position handles moderate to complex... ...necessary information to ensure policy applicability. Objectively discern and... ...Remarkable benefits: • Health coverage for medical, dental, vision • 401(K) saving plans...Remote workSeniorPolicyMedicalClaimsFull timeWork at officeLocal area$141.59k - $176.99k
...Description Summary:The Senior Preconstruction Project Manager is responsible for... ...in San Diego, CA or remote to start with... ...according to Company policy Organize regular meetings... ...) Avoid or mitigate claims and conflict... ...families) are eligible for medical, dental, vision, basic...Remote workSeniorPolicyMedicalClaimsFull timeContract workFor subcontractorWork at office- Brighton Health Plan Solutions, LLC seeks a Senior Manager of Medical and Clinical Claim Policy and Configuration to lead policy content, policy publication... ...Medical Management, Claims, IT, and Operations. This remote role requires deep expertise in medical and claims...Remote jobSeniorPolicyMedicalClaims
- Position: Senior Security Engineer - PKI &... ...through Thursday; remote Monday and Friday)... ...and supporting key-management processes.Partner... ...EST, Certificate Policy/Certification Practice... ..., including medical, dental, vision, and... ...email, or phone call claiming to be from PTR...Remote workSeniorPolicyMedicalClaimsFull timeMonday to Friday
$115k - $175k
...Adoption Services, the Senior Consultant plays a... ..., pipeline management, coaching, and sales... ...Gongsters a variety of medical, dental, and... ...you succeed in a remote environment.The annual... .... Any outreach claiming to be from Gong via... ...review Gong's privacy policy, visit for more...Remote workSeniorPolicyMedicalClaimsWork from homeFlexible hours
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