Kirby Bates Associates, a premier national healthcare leadership firm, is seeking a Claims Processing Oversight Consultant to support a large, organization in Missouri.
This senior-level consultant will provide hands-on configuration oversight, root-cause analysis leadership, and executive advisory support, ensuring the accuracy, integrity, and compliance of medical claims processing across FEHB and PSHB lines of business.
Requirements
- 15+ years of payer claims operations leadership
- Direct experience with major claims platforms — Facets, HealthRules, QNXT, NASCO, or proprietary platforms at production scale
- Demonstrated RCA capability — has personally led root-cause analysis on claims defects that became regulator-facing issues
- Track record of configuration root-cause work that has survived external audit
- Federal program claims operations experience — FEHB, PSHB, Medicare Advantage, Medicaid, or Tricare
- Must be able to be on site every other week.
Our leaders receive an attractive compensation package including housing, transportation, and regular travel home.
Kirby Bates Associates is an EEO/AA Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender, gender identity and expression, national origin, age, disability or protected veteran status. We celebrate diversity and are committed to creating an inclusive environment for all of our associates.