Senior Ops Leader - Denials & Claims Optimization

NEXT Ai PRESS; Mountain View (CA); On-site; USD 120,000 - 180,000; Full time

Job summary

Commure is seeking a Senior Operations Manager to drive denials management and claims optimization within the Business Operations team at Mountain View, CA. You will lead strategy, design scalable workflow solutions, and partner with clients and account managers to implement improvements.

Ideal candidates have 4+ years in healthcare operations, strong data analysis skills (Excel required, SQL preferred), and a proven track record of leading cross-functional initiatives at scale.

Qualifications

• 4+ years of experience in healthcare operations, revenue cycle management, healthcare consulting, or related roles.
• Strong analytical skills with ability to independently perform data analysis (Excel required; SQL strongly preferred).
• Operational leadership with a track record of managing cross-functional initiatives and improving process performance at scale.
• Systems thinking ability; Ownership mindset; Excellent communication skills; Bias for action.

Responsibilities

• Lead Denials Management Strategy by overseeing the claims lifecycle from post-submission to resolution and designing scalable solutions to reduce friction and revenue loss.
• Drive Root Cause Analysis to investigate systemic issues behind rejections and denials and implement preventative solutions.
• Own Key Operational Metrics by managing throughput, denial rates, and other metrics for high-profile client accounts.
• Build and Scale Processes by designing repeatable, automated workflows and collaborating with product and engineering to define requirements for internal tooling.
• Serve as a Client Partnership subject matter expert to partner with account managers and clients to troubleshoot issues and implement operational improvements.

Skills

Data analysis

SQL

Excel

Cross-functional leadership

Communication

Operational metrics

Job description

Commure is seeking a Senior Operations Manager to drive denials management and claims optimization within the Business Operations team at Mountain View, CA. You will lead strategy, design scalable workflow solutions, and partner with clients and account managers to implement improvements.

Ideal candidates have 4+ years in healthcare operations, strong data analysis skills (Excel required, SQL preferred), and a proven track record of leading cross-functional initiatives at scale.