Medical Claims Review Manager jobs in New York

About Alaffia & Our Mission

The U.S. healthcare system suffers from over $300B in improper payments each year due to fraud, waste, abuse, and processing errors. We’re on a mission to change that. To best prevent inaccurate payments, we’ve assembled a team of experienced technologists and industry-leading healthcare domain experts. The Alaffia team has alumni ranging from Amazon, Goldman Sachs, the Centers for Medicare and Medicaid Services, and other leading healthcare and financial institutions. We’re also backed by industry-leading venture capital firms!

If you want to make a major impact at the core of U.S. healthcare by implementing the latest in cutting-edge technologies, then we’d like to meet you.

Our Culture

At Alaffia, we fundamentally believe that the whole is more valuable than the sum of its individual parts. Further to that point, we believe a diverse team of individuals with various backgrounds, ideologies, and types of training generates the most value. Our people are entrepreneurial by nature, problem solvers, and passionate about what they do — both inside and outside of the office.

About the Role & What You’ll Be Doing

Joining our team as an Account Manager for our Bill Review Clients means being at the forefront of Alaffia's commitment to excellence in client service and satisfaction. You will play a pivotal role in managing our client portfolio, ensuring their needs are met, and fostering long-term relationships that drive mutual success. As a key liaison between Alaffia and our clients, you'll have the opportunity to make a meaningful impact by identifying growth opportunities and ensuring our solutions continue to meet and exceed expectations. In this role, you'll play a vital role in nurturing relationships with clients, understanding their needs, and proactively addressing any concerns or challenges that may arise. 

You'll lead the implementation and onboarding of new clients and solutions, ensuring a seamless transition and setting the stage for long-term success. Additionally, you'll collaborate closely with internal teams to drive strategic initiatives, identify opportunities for improvement, and ensure that our clients receive the highest level of service and support. With your strong communication skills and customer-centric approach, you'll play a critical role in shaping the future of Alaffia and helping our clients achieve their goals.

Your Responsibilities

• Managing a portfolio of clients to achieve operation objectives, retain revenue, and identify upsell opportunities
• Understand client scope of work and serve as the client advocate when working with internal teams to ensure that client needs are understood and satisfied
• Facilitate new client onboarding, training, and implementation, ensuring a smooth client experience from claim receipt, claim review, and delivery of claim analysis reports
• Build and nurture strong relationships with clients to position Alaffia as a trusted partner
• Ensure existing clients understand and appreciate the value of Alaffia's solutions, fostering satisfaction and loyalty
• Collaborate with internal stakeholders to effectively manage client accounts and address client needs
• Contribute to projects, process improvements, and strategic initiatives involving cross-functional teams
• Coordinate all aspects of client meetings, ensuring key objectives are defined, organized, and communicated effectively
• Triage client support requests and tickets and ensure all issues are resolved promptly, closing the loop amongst all necessary stakeholders
• Collaborate with our Payment Integrity team to understand and effectively communicate analysis results to all necessary stakeholders

What We’re Looking For

• Relevant experience within the healthcare insurance industry, technology, and data
• 5 years of professional experience in hospital bill reviews, claims negotiation, and provider relations
• 3 years experience working at a payer organization (insurance company)
• Prior experience working at a payment integrity firm is highly desired
• Previous experience working as an account manager or customer service representative
• Deep understanding of health insurance, medical billing and coding, and payment integrity
• Excellent presentation, oral and written communication skills
• Experience working with CRM databases (Ex. Salesforce, Hubspot)
• Must be detail-oriented and flexible to work in a fast-paced, dynamic environment
• Proven ability to cultivate and maintain strong professional relationships with stakeholders at all levels
• Strong project management skills with experience in planning, organizing, and executing effectively
• Proficiency in Microsoft Excel, Word, and PowerPoint
• Strong problem-solving skills with a collaborative approach
• Results-oriented and self-motivated with keen attention to detail
• Prior experience in contract negotiations (preferred)

What Else Do You Get Working With Us?

• Medical, Dental, and Vision benefits
• Flexible, paid vacation policy
• Work in a flat organizational structure — direct access to Leadership

LI-REMOTE