Director, Claims Support

Millennium Physician Group

Director of Claims Support managing claims administration and operational leadership at CareMore Health. Ensuring compliance with regulatory requirements and driving operational excellence across markets.

Posted 7/15/2026full-timeRemote • Arizona, California, Nevada • 🇺🇸 United StatesLead💰 $144,368 - $238,207 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in healthcare claims operations, including claims intake, adjudication, and provider reimbursement, while ensuring compliance with CMS, Medicare Advantage, and Medicaid regulations. Proven leadership in managing teams, driving operational transformation, and implementing continuous improvement initiatives.

Highest-signal resume keywords

Healthcare Claims OperationsLeadership ExperienceRegulatory ComplianceOperational Metrics ManagementStrategic Planning

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims AdjudicationProvider ReimbursementOperational TransformationContinuous ImprovementBudgetingProductivity StandardsQuality IndicatorsAutomationPayment AccuracyClaims Processing

Soft Skills

LeadershipCoachingCollaborationProblem-SolvingCommunication

Industry Keywords

Medicare AdvantageMedicaidManaged CareHealth PlanPayer EnvironmentsClaims IntakeProvider DisputesSLA MonitoringOperational MetricsHealthcare Administration

About the role

Key responsibilities & impact

Direct all aspects of claims intake, adjudication, payment, adjustment, and provider reimbursement activities.
Ensure claims are processed accurately, timely, and in compliance with contractual, regulatory, and organizational requirements.
Provide leadership and guidance on highly complex claims and provider disputes.
Establish and monitor operational metrics, SLAs, productivity standards, and quality indicators.
Lead continuous improvement initiatives focused on automation, efficiency, payment accuracy, and provider experience.
Ensure compliance with CMS, Medicare Advantage, Medicaid, and state regulations.
Lead strategic planning, budgeting, workforce planning, and operational transformation initiatives.
Partner with providers, delegated entities, vendors, and internal stakeholders to resolve issues and improve performance.
Lead, coach, and develop managers and claims professionals across multiple locations.

Requirements

What you’ll need

Bachelor's degree in Business Administration, Healthcare Administration, Finance, Public Health, or related field, or equivalent experience.
Minimum 9 years of progressive healthcare claims operations experience.
Minimum 5 years of leadership experience managing managers and/or large operational teams.
Experience within Medicare Advantage, Medicaid, Managed Care, Health Plan, or Payer environments.

Benefits

Comp & perks

3 weeks PTO & 8 paid holidays
Medical, Dental, Vision
Employer Paid Basic Life & Short Term Disability coverage (goes into effect after 1 year of full-time employment)
401(k) with match
Employee Wellness
Other Employee Discount programs like Tickets at Work and cell phone discounts
Other benefits: Dependent Care FSA, Voluntary Life, Long Term Disability, Critical Illness, Pet Insurance, and more