Remote Medical Operations Lead – Billing & Disputes

Texas Mutual Insurance Company; Austin (TX); Hybrid; USD 102,000 - 127,000; Full time

Benefits offered by this job

Annual bonus

401k match

Health insurance

Gym access

Paid time off

Tuition reimbursement

Some remote work

Job summary

Texas Mutual Insurance Company in Austin, Texas, is seeking a Supervisor Medical Operations to oversee inpatient facility bill audit operations, medical fee dispute resolution, and vendor and compliance management within the Texas workers' compensation system.

The ideal candidate has 5+ years of experience in Texas workers' compensation or medical bill review, with at least 2 years in a supervisory role, strong data analytics, and a proven ability to drive process improvement in a fast-paced

Qualifications

• Education: Bachelor’s degree or equivalent in a related field.
• Experience: 5+ years in Texas workers' compensation, medical bill review, or managed care, with 2+ years in a supervisory role.
• Expertise in TDI-DWC rules, CMS billing guidelines, and Texas workers' compensation medical fee guidelines.

Responsibilities

• Oversee inpatient facility bill audit operations and medical fee dispute resolution.
• Manage vendor and compliance management within the Texas workers' compensation system.
• Develop cost containment strategies and drive process improvements in a dynamic environment.

Skills

Texas WC regs

CMS billing guidelines

Data analysis

Team leadership

Contract negotiation

Cross-functional collaboration

Communication

Action orientation

Adaptability

Analytical thinking

Process improvement

Education

Bachelor's degree in Health Administration, Business, Finance, Healthcare Management, or related field

Job description

Texas Mutual Insurance Company in Austin, Texas, is seeking a Supervisor Medical Operations to oversee inpatient facility bill audit operations, medical fee dispute resolution, and vendor and compliance management within the Texas workers' compensation system.

The ideal candidate has 5+ years of experience in Texas workers' compensation or medical bill review, with at least 2 years in a supervisory role, strong data analytics, and a proven ability to drive process improvement in a fast-paced