Healthcare Claims Project Manager

A company is looking for a Project Manager - Healthcare Claims Management. Key Responsibilities Lead and manage end-to-end projects focused on healthcare DME claims Serve as the subject matter expert for claims workflows, system configurations, and industry best practices Ensure claims-related projects meet compliance with HIPAA, CMS, Medicaid, and other applicable regulations Required Qualifications Bachelor's degree in healthcare administration, business, or related field, or equivalent experience required 5+ years of experience in healthcare claims management, with at least 3 years in a project management capacity Deep knowledge of claims adjudication systems (e.g., QNXT, Facets, HealthEdge) and HIPAA EDI transactions Proven experience leading cross-functional projects in a payer or managed care environment Strong understanding of CMS, Medicaid, and state-specific claims regulations