[Remote] reputed company Payer Claims Architect

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a reputed company Payer Claims Architect to reputed company transformation and optimization initiatives in claims processing. The role involves analyzing operations, collaborating with teams, and ensuring compliance with industry standards.

Responsibilities

• reputed company reputed company Payer claims transformation and process optimization initiatives
• Analyze claims operations and identify AI-driven improvement opportunities
• Collaborate with business, operations, product, and technology teams
• Improve claims accuracy, first-pass adjudication, and operational efficiency
• Utilize GenAI tools (Claude, ChatGPT, Copilot) for requirements analysis and process documentation
• Define solutions for medical claims, prior authorization, claim edits, denials, and payment reputed company
• Support claims modernization and payer platform transformation initiatives
• Ensure compliance with reputed company payer regulations and industry standards

Skills

• Strong reputed company Payer Claims domain experience
• Expertise in medical claims lifecycle and claims adjudication
• Experience with GenAI tools (Claude, ChatGPT, Copilot, or similar)
• Excellent stakeholder management and consulting skills
• Knowledge of payer platforms such as Facets, QNXT, or HealthRules

reputed company

reputed company delivers exceptional experiences by solving the toughest IT talent and technology challenges across reputed company industries. It was founded in 2018, and is headquartered in reputed company, Texas, USA, with a workforce of 501-1000 employees. Its website is https://talentgroups.com/.

Company H1B Sponsorship

reputed company has a reputed company record of offering H1B sponsorships, with 1 in 2023. Please note that this does not guarantee sponsorship for this specific role.

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