7 Payer Policies Jobs

Job Description Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts comprehensive portfolio, including the CareLogic, Credible, and InSync platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a l...

Job Description Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts comprehensive portfolio, including the CareLogic, Credible, and InSync platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a l...

At Commure, our mission is to simplify healthcare. We have bold ambitions to reimagine the healthcare experience, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans ambient AI clinical documentation, provider copilots, autonomous coding, revenue cycle management and more all designed for providers & administrators to focus on what matters most: providing care. Healthcare is a $4.5 trillion industry with more than $500 billion spent annually on administrative costs, and Commure is at the heart of transforming it. We power over 500,000 clinicians across hundreds of care sites nationwide more than $10 billion flows throu...

OverviewApplication At Commure, our mission is to simplify healthcare. We have bold ambitions to reimagine the healthcare experience, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans ambient AI clinical documentation, provider copilots, autonomous coding, revenue cycle management and more all designed for providers & administrators to focus on what matters most: providing care. Healthcare is a $4.5 trillion industry with more than $500 billion spent annually on administrative costs, and Commure is at the heart of transforming it. We power over 500,000 clinicians across hundreds of care sites nationwide more than $10...

# Quality Manager Medical Billing Location: Mohali, Pune, Chennai and Salem No. Positions: 4 Industry: Healthcare / Revenue Cycle Management (RCM) About the Role We are looking for an experienced Quality Manager to lead quality assurance in our medical billing operations. The ideal candidate will ensure process excellence, compliance with payer regulations, and continuous improvement across RCM functions. Key Responsibilities Establish and monitor quality standards across Medical Billing, AR follow-up, and denial management. Conduct regular audits, reviews and root cause analyses to identify gaps and implement corrective actions. Collaborate with operations, training and compliance teams to ...

About the Role Were seeking a Denials Team Lead with hands-on experience across both inpatient and outpatient denials to drive overturns, reduce aged inventory, and prevent recurrence at the root cause. Youll lead a pod of denial analysts, set daily priorities, coach for quality and speed, and collaborate with Coding, Charge Entry, Registration, and Payer Relations to improve first-pass yield and cash acceleration. Key Responsibilities Team Leadership & Delivery Lead a team of denial analysts across IP/OP workqueues; plan capacity, assign work, and monitor performance. Run daily huddles; set targets for productivity, quality, and TAT; remove blockers and manage escalations. Conduct 1:1s, coa...

# Associate Director Medical Billing Location: Hyderabad, Pune, Mohali, Bangalore, Chennai, Salem and Trichy No. Positions: 8 Industry: Healthcare / Revenue Cycle Management (RCM) About the Role We are looking for an experienced Associate Director Medical Billing to manage operations and lead high-performing teams within our healthcare RCM practice. The ideal candidate will be responsible for ensuring billing accuracy, driving productivity, strengthening client relationships, and supporting organizational growth. Key Responsibilities Oversee daily medical billing operations (charge entry, Medical Billing, AR, denials, collections). Drive operational efficiency through process improvement and...