Director, Billing Claims & Member Navigation

Rightway; Denver (CO); On-site; USD 69,000 - 86,000; Full time

Job summary

Rightway is seeking a seasoned Manager to lead Billing Claims and Health Systems Navigation Service Delivery for Rightway Healthcare. This role operates from the Denver satellite office and partners with senior management to align day-to-day operations, optimize processes, and resolve member billing and claims issues.

The role requires strong leadership, 5+ years in healthcare billing, and the ability to coach a team of 8–15 Health Guides while driving KPI performance and collaborating across

Qualifications

• 5+ years of healthcare billing or claims processing.
• 3+ years of contact center management preferred.
• Bachelor’s Degree in Management or Healthcare is highly preferred.

Responsibilities

• Lead, motivate, coach, and mentor a team of Health Guides (8–15 members).
• Drive KPI Performance (SLA, Abandon Rates, Chat Response Times, TATs).
• Assign, review, and monitor workload to ensure timely member requests.
• Develop and maintain Standard Operating Procedures for the team.
• Work with cross-functional teams to drive training, quality, workforce, and product improvements.
• Interview, hire, and onboard new team members.
• Handle escalations and conduct RCAs with action plans.

Skills

Billing & claims processing

Leadership

KPI management

Healthcare terminology

Communication

Employee coaching

Education

Bachelor’s Degree in Management or Healthcare

Job description

Rightway is seeking a seasoned Manager to lead Billing Claims and Health Systems Navigation Service Delivery for Rightway Healthcare. This role operates from the Denver satellite office and partners with senior management to align day-to-day operations, optimize processes, and resolve member billing and claims issues.

The role requires strong leadership, 5+ years in healthcare billing, and the ability to coach a team of 8–15 Health Guides while driving KPI performance and collaborating across