Claims Adjudication Product Manager - Medicare/Medicaid
Navitus Health Solutions
Navitus Health Solutions is looking for a Product Manager specializing in Claim Adjudication focused on Medicaid/Medicare. This remote position requires strong expertise in claims processing and audit processes. The CAPM will ensure compliance with CMS regulations and improve claims accuracy while collaborating with various teams. Responsibilities include overseeing audits, leading root cause analysis projects, and maintaining training resources. The role comes with top industry benefits, generous paid time off, and a supportive work environment. #J-18808-Ljbffr
$82.59k - $101.33k
...Product Manager, Claim Adjudication, Medicaid/Medicare Location: Remote ID: 2026-5739 Category: Development Position Type: Full-Time Pay Range: USD $82,586.00 - USD $101,333.00 /Yr. Work Schedule: M-F 8am to 5pm CT Remote Work Notification: ATTENTION: Navitus is unable...ClaimsFull timeRemote workFlexible hours$74.7k - $187k
...Job Description We are seeking a Product Manager to drive the expansion of Oracle's healthcare claims adjudication platform for the United States market. Our existing... ...Experience with commercial, Medicare, Medicaid, or government healthcare programs. Familiarity...ClaimsTemporary workFlexible hours$63.83k - $76.9k
...Assoc. Product Manager, Innov. Pharm. Prog. Location US- ID 2026-6088... ...Analyze, document and report any issues with claims associated with assigned products... ...standard templates to document how claims adjudicate and share finding with all impacted functional...ClaimsFull timeRemote workFlexible hours$71.2k - $158.2k
...Reporting Understand Medicare data, data design, and... ...member, provider, and claim Create novel and... ...designs for Medicare and Medicaid solutions Partner... ...market opportunities to management Responsibilities... ...T-MSIS reporting ~ Product management Preferred...ClaimsTemporary workWork experience placementFlexible hours- ...State Product Manager-Nonstandard Auto The State Product Manager-Nonstandard Auto is responsible for increasing profit, premium, and market... ..., as needed, in collaboration with Analytics, Actuarial, Claims, and Compliance areas Leverage expert knowledge within assigned...ClaimsContract workWork experience placementWork at officeImmediate startWork from homeHome officeMonday to Friday
$91.4k - $187k
...clinician burden. We are seeking a highly motivated Senior Product Manager to lead product strategy, roadmap, and execution for AI-enabled... ...platforms. Experience with prior authorization, claims management, eligibility verification, remittance processing,...ClaimsTemporary workWorldwideFlexible hours$113k - $194k
...Description Insurance Product Management experience is required! As a product manager, you'll be accountable for the P&L of American Family... ...line P&G initiative analysis Primary contact with claims for Work Comp line of business Primary contact with UW support...ClaimsFull timeContract workWork at officeLocal areaRemote workRelocation package$20 - $24 per hour
...reimagining medication management and transforming care.... ...bills and insurance claims in an accurate and timely... ...party by running Medicare plan comparisons during... ...Perform prescription claims adjudication including... ...requirements (Medicare, Medicaid, Prescription Drug Plans...ClaimsHourly payFull timeTemporary workWork at officeMonday to FridayFlexible hours$90k - $100k
...the innovative solutions at Natus Neuro . JOB TITLE: Product Manager PSG DEPARTMENT: Commercial SHIFT: Full Time... ...Category Director in assessing the needs for additional clinical claims, commercial support/structure, and technical expertise...ClaimsFull timeRemote workShift work- ...We are adding a Claims Adjudicator to our team! Who We Are: Since 1909, National Guardian... ...We specialize in a suite of innovative products for life's journey, giving people the financial... ...to teammates when the need arises Manage and adjust personal time off, breaks,...ClaimsHourly payFull timeTemporary workWork at officeLocal areaRemote workMonday to FridayFlexible hoursShift work
$91.4k - $187k
...Description Oracle Health is seeking an experienced Senior Product Manager to support product operations, release readiness, regulatory... ...platforms. Experience with prior authorization, claims management, eligibility verification, remittance processing,...ClaimsTemporary workFlexible hours$63.93k - $76.9k
...Supervisor, Claim Adjudication Operations Location US- ID 2026-6024 Category Administration Position... ...was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug...ClaimsFull timeWork experience placementWork at officeRemote workFlexible hours$149k - $253k
...Position Overview The Principal Screening Product Strategy Director is responsible for... ...Diagnostics’ screening business. As the product management evidence strategy lead, this individual... ...generation aligned to product and claims strategy. Communicate goals clearly to cross...ClaimsFull timeFor contractorsLocal areaNight shift- ...pre-treatment estimates and financial letters. Post Charges, payments, and denials. Enter patient demographics. Process Medicaid HMO claims and pre-authorizations for MA. File insurance claims for theHMO’s. Provide customer service for those calling into the...ClaimsTemporary workWork at officeMonday to Friday
$160.98k - $265.87k
...Key Responsibilities Own product definition for Computers for Agents across segments –... ...POCs that validate vertical integration claims (IT operations, DevOps, regulated industry... ...related academic field. 6+ years of product management experience with a Bachelor's degree, 4+...ClaimsLocal area$38k - $65k
...Corporation in Madison, WI is looking for a Triage Order Quality Associate Level II (TOQII) to ensure accurate filing of insurance claims. This role requires a strong understanding of medical insurance and the ability to interact with various payors. Candidates should...ClaimsMonday to Friday- ...full-time position offers a hybrid work opportunity, allowing flexibility after training. Responsibilities include billing medical claims to insurance, resolving claim holds, and assisting patients with billing questions. The ideal candidate will have experience in healthcare...ClaimsFull time
$193.2k - $227k
...Type: FullTime Location Type: Remote Department Product Compensation: $193.2K - $227K - Offers Equity At Confluent... ...Data Streaming Platform. About the Role: As a product manager on the Platform team, you will be responsible for empowering developers...Full timeRemote work$24.5 - $26 per hour
...Carrington is seeking a Default FHA Claims QA Analyst II to work remotely in Madison, Wisconsin. In this role, you will be responsible for reviewing FHA mortgage insurance claims for accuracy while adhering to state and federal laws. The position requires two years of...ClaimsHourly payRemote work- ...an Appeals Nurse responsible for examining medical records and claims for first-level appeal cases. The role involves reviewing denied... ...with redetermination representatives to ensure compliance with Medicare guidelines. Qualified candidates should have a nursing degree...ClaimsRemote work
$131k - $220k
...lead a team responsible for Commercial products design and development in collaboration... ...identification, enterprise service linkage, vendor management and research. Oversee product... ...actuarial, product, underwriting, claims, legal/compliance and IT Specialized...ClaimsFull timeTemporary workWork at officeLocal areaRelocation packageFlexible hours- ...M3 Insurance is seeking a Claims Support Specialist in Madison, WI. This role involves supporting the Risk Management Department with claim intake, managing compensation claims, and providing guidance to clients. Applicants should have at least one year of claims experience...ClaimsFlexible hours
- ...investigative services. We investigate all types of insurance claims including workers' compensation, suspected fraud, liability and... ...complete the assignment as per the instructions given by the case manager. Key Responsibilities: Adhere to specific requirements of...ClaimsFlexible hours
- ...A leading financial technology firm is seeking a Senior Product Manager for its growing team. This role involves managing product growth through technical SEO and innovative strategies while using data to guide product decisions. The ideal candidate has 5+ years of experience...Remote work
$54.24k - $64.57k
...alternative to traditional pharmacy benefit manager (PBM) models. We are committed to... ...and geographies (Commercial, Medicare and managed Medicaid). This position will be expected to... ...care processes and pharmaceutical claims adjudication systems preferred Participate in...ClaimsFull timeContract workRemote workFlexible hours- ...Hancock Claims Consultants specialize in Ladder Assist and Property Inspection Services, collaborating directly with numerous insurance agencies for efficient claims management. At Hancock, we are at the forefront of claims resolution services, offering nationwide coverage...ClaimsPermanent employmentFor contractors
- ...projects by performing reconciliations, managing financial information, and... ...workflows remain compliant with Centers for Medicare & Medicaid Services (CMS) requirements. Hourly... ...small to large businesses. We process claims and provide customer support for beneficiaries...ClaimsHourly payContract workFor contractorsLocal areaImmediate startRemote work
- ...Gainwell Technologies is seeking a Sr. Batch Developer (UNIX/C/SQL/Claims) to contribute to innovative health solutions. This remote... ...6 years of programming experience and a clear understanding of Medicaid Claims systems. Gainwell offers competitive salary packages, career...ClaimsRemote work
- ...is seeking an experienced billing professional to manage the full revenue cycle for skilled nursing... ...involves overseeing accurate billing processes for Medicare, Medicaid, and commercial payers, resolving complex claim issues, and collaborating with internal teams. Candidates...Claims
- ...A leading software services company is seeking a Field Claims Representative in Wisconsin to manage on-site insurance property claim inventories. The role involves assisting with business development, maintaining customer relations, and coordinating with the scheduling...ClaimsFull timeWork at officeLocal areaRemote workFlexible hoursNight shift
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