Curana Health is a provider of value-based primary care services for the senior living industry, including skilled nursing facilities, assisted & independent living communities, Memory Care units, and affordable senior housing sites. Our 1,000+ clinicians serve more than 1,500 senior living community partners across 34 states, and Curana participates in various innovative CMS programs (including owned-and-operated Accountable Care Organizations and Medicare Advantage plans). With rapid year-over-year growth since our founding in 2021, Curana is setting a new standard in innovative care delivery for seniors with high-risk, complex clinical needs, many of whom have been historically underserved by the healthcare system. Our mission: To radically improve the health, happiness and dignity of senior living residents.

A Medicare Claim Manager oversees the processing, evaluation, and resolution of Medicare insurance claims. Their role is crucial in ensuring claims are handled efficiently, accurately, and in compliance with regulations.

• Claims Processing: Ensure timely and accurate processing of Medicare claims.
• Compliance: Monitor adherence to healthcare regulations and policies.
• Vendor Management: Manage relationship with vendors.
• Team Management: Supervise and train claims processing staff.
• Issue Resolution: Address complex or escalated claims disputes.
• Data Analysis: Identify trends and areas for improvement in claims handling.
• Process Improvement: Develop and implement strategies to enhance efficiency.
• Reporting: Prepare regular reports and performance metrics.
• Auditing: Conduct internal audits to ensure quality and compliance.

• Bachelor's degree in healthcare administration, business, or related field or equivalent experience.
• Extensive knowledge of Qnxt Claims Administration system.
• Minimum 8 years of experience in Medicare claims processing.
• Strong knowledge of medical terminology and billing codes (ICD, CPT, HCPCS).
• Familiarity with insurance policies and healthcare regulations.
• Excellent leadership and team management skills.
• Strong analytical and problem-solving abilities.

Curana Health is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances.

The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment.

*The company is unable to provide sponsorship for a visa at this time (H1B or otherwise).