Hybrid Claims Analytics Manager

Posted 5 days ago

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About the role

  • Claims Analytics Manager leading claims analytics and overseeing reimbursement analyses at Rialtic, Inc. Mentoring a team and collaborating cross-functionally for client implementations.

Responsibilities

  • Lead and mentor a team of Implementation Claims Analysts, setting priorities, performance expectations, and development plans.
  • Define and standardize analytical methodologies, reporting frameworks, and best practices for claims and reimbursement analysis.
  • Partner with Implementation leadership to align analytics deliverables with client goals, timelines, and success metrics.
  • Act as a subject-matter expert in claims analytics for complex or high-visibility client implementations.
  • Oversee large-scale analysis of claims data related to charge capture, reimbursement, underpayment, overpayment, and payment accuracy.
  • Ensure the delivery of exception-driven, actionable insights that clearly identify systemic versus isolated issues.
  • Review and validate analytical outputs, ensuring accuracy, consistency, and clarity in reporting and client-facing deliverables.
  • Guide analyses related to payor reimbursement behavior and trends, RVU productivity and payment alignment, revenue cycle optimization opportunities, and financial performance to benchmarks, goals, and norms.
  • Partner with GTM and Customer Success teams to support implementations, renewals, and expansion opportunities through analytics insights.

Requirements

  • 8+ years of experience in healthcare claims analytics, payment accuracy, or reimbursement analysis.
  • Prior experience working with claims editing or payment accuracy vendors.
  • Strong expertise in medical coding, billing guidelines, and reimbursement methodologies.
  • Proven people leadership experience managing and developing analytics teams.
  • Advanced proficiency in SQL and experience working with large healthcare datasets.
  • Strong executive communication and presentation skills.

Benefits

  • Health insurance
  • 401(k) matching
  • Flexible working hours
  • Paid time off
  • Remote work options

Job title

Claims Analytics Manager

Job type

Experience level

SeniorLead

Salary

Not specified

Degree requirement

Bachelor's Degree

Tech skills

Location requirements

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