Claims Reconciliation Manager

The Claims Reconciliation Managerat Veuu plays a critical role in analyzing, reviewing, and resolving complex claims, particularly those in the dead letter claim queue. This position requires deep expertise in claims processing, reimbursement methodologies, and regulatory compliance to enhance claim reconciliation and ensure accurate financial outcomes. The Reconciliations Manager will collaborate with internal and external stakeholders to optimize claim resolution processes, drive efficiency, and provide strategic insights to improve overall claims management.

Job Summary

• Manage day-to-day reconciliations and reporting, and vendor management (as needed)
• Act as the domain expert on claim reconciliation, providing insights and solutions for resolving stalled claims.
• Analyze trends within the dead letter claim queue, identifying root causes and implementing corrective actions.
• Develop comprehensive claim review strategies to enhance accuracy and minimize revenue loss.
• Generate and present claim reconciliation reports, offering data-driven recommendations to leadership.
• Work closely with Veuu’s operations, compliance, provider, and payer teams to address claim discrepancies and ensure timely reimbursement.
• Provide training and guidance to internal teams on best practices in claims reconciliation and industry regulations.
• Recommend process improvements and technology enhancements to streamline claim resolution.
• Ensure compliance with payer policies, healthcare regulations, and industry standards.

• Strong knowledge of healthcare claims processing, payment reconciliation, and reimbursement methodologies.
• Familiarity with CMS guidelines, payer policies, HIPAA, and industry regulations.
• Ability to identify payment discrepancies, analyze trends, and implement solutions.
• Experience with claims management systems, EHR platforms, and financial reconciliation tools.
• Skilled in assessing workflows and recommending improvements to streamline claim resolution.
• Ability to interpret and leverage claims and payment data for strategic insights.
• Strong ability to work across departments, liaise with payers, and educate teams on best practices.
• Self‑motivated, results‑driven, and able to navigate evolving industry trends and regulations.
• Committed to maintaining accuracy, integrity, and compliance in financial transactions.
• Open‑minded and adaptable approach to problem‑solving
• Self‑motivated and driven to achieve results
• Effective multitasking and organizational skills
• Enthusiastic and eager to learn and explore new methodologies
• Ability to thrive in a fast‑paced and dynamic work environment
• Analyze and resolve complex claims and payment discrepancies, particularly within the dead letter claim queue, ensuring accurate financial reconciliation and minimizing revenue leakage.
• Leverage AI‑driven reconciliation tools to automate claim reviews, detect payment variances, and enhance efficiency, accuracy, and compliance with payer policies.
• Partner with internal teams (billing, coding, finance, compliance) and external partners, clients, providers and payers to resolve payment variances, drive process improvements, and ensure seamless claim resolution.
• Utilize AI‑powered analytics to generate actionable reports on claim trends, payment reconciliation outcomes, and financial variances while ensuring compliance with regulatory and contractual requirements.
• Optimized data models for improved accuracy and relevance
• Enhanced data infrastructure, processes, and reporting capabilities
• Increased productivity and efficiency through data‑driven insights
• Identification and implementation of improvement strategies based on analysis

• Bachelor’s degree in healthcare administration, finance, business, or a related field (or equivalent experience).
• Extensive experience in claims reconciliation, medical billing, coding, or healthcare revenue cycle operations.
• Expertise in medical coding (ICD‑10, CPT, PCS, HCPCS), reimbursement methodologies, and payer regulations.
• Strong analytical, problem‑solving, and process optimization skills.
• Proficiency in claims management systems, EHR platforms, and reporting tools.
• Excellent…