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Claims Compliance Leader, TPA Operations at heathos | Kimble Group

Claims Compliance Leader, TPA Operations

heathosAlpharetta, GA

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Claims Compliance Leader, TPA Operations

heathosAlpharetta, GASenior L5

Medical and Health Services Managers Compliance Managers Regulatory Affairs Managers

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds All Other Insurance Related Activities Direct Health and Medical Insurance Carriers

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Heathos LLC in Alpharetta, GA seeks a Claims Compliance Manager, TPA to oversee regulatory and operational compliance within a health claims TPA environment. This functional leadership role partners with Claims Operations, Network Repricing, Vendor Management, and Leadership to ensure compliant claims processing. The ideal candidate has 5+ years in health Claims TPA, experience with 837/835 workflows, fee schedules, EOBs, and delegated vendor oversight, plus HIPAA Privacy & Security knowledge.

Matching similar jobs

Level

Senior L5

Location

Alpharetta, GA

Occupation

Medical and Health Services Managers

Industry

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Posted

2 days ago

APPLY NOW (opens in a new tab)