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Role Scope:
- Ensures accuracy, timeliness, and quality of service authorizations.
- Collaborates across functions to resolve data discrepancies.
- Provides leadership with actionable insights for process improvement.
Responsibilities:
- Oversees adjudication operations and maintains a compliant environment.
- Establishes reports to support service authorization efficacy.
- Monitors encounter data submissions for accuracy.
Qualifications:
- 7+ years of experience in health insurance operations with team leadership.
- Expertise in claims processing and utilization management.
- Bachelor’s degree in healthcare, finance, or related field required.
Habitat Health
Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with our leading healthcare partners, including Kaiser Permanente. They are redefining aging in place and building engaged, fulfilled care teams to deliver personalized care.