Director of Claims & Revenue Integrity

Adobe Population Health; Phoenix (AZ); Presencial; USD 120.000 - 180.000; Jornada completa

Descripción de la vacante

Adobe Population Health seeks a Director of Claims to lead the organization’s claims lifecycle—submission, adjudication, payment, and collection—while reducing denials and ensuring compliant, timely reimbursement. The role partners across Clinical Operations, IT, and Finance to optimize workflows and revenue integrity.

The position is based in Phoenix, with a focus on building scalable processes, dashboards, and data-driven improvements to support high-quality population health services.

Formación

• Seven years of progressive healthcare claims experience.
• Three years of leadership experience managing claims, billing, or reimbursement teams.
• Experience with revenue cycle management and payer follow-up.
• Strong understanding of claims submission, denial management, and appeals.
• Knowledge of payer billing requirements and contractual terms.

Responsabilidades

• Oversee end-to-end claims lifecycle from submission to collection.
• Manage claims inventory and aging to ensure timely processing.
• Establish workflows for submission, denial resolution, and appeals.
• Monitor denial trends and implement corrective actions with stakeholders.
• Lead payer follow-up, collections, and revenue recovery.
• Ensure billing readiness and contract implementation for new services.
• Develop KPIs and dashboards to drive performance.

Conocimientos

Healthcare claims exp

People leadership

Revenue cycle management

Payer follow-up

Descripción del empleo

Adobe Population Health seeks a Director of Claims to lead the organization’s claims lifecycle—submission, adjudication, payment, and collection—while reducing denials and ensuring compliant, timely reimbursement. The role partners across Clinical Operations, IT, and Finance to optimize workflows and revenue integrity.

The position is based in Phoenix, with a focus on building scalable processes, dashboards, and data-driven improvements to support high-quality population health services.