INSPYR Solutions
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Base pay range
$85.00/hr - $110.00/hr Job Title:
Medicare Claims Integration Consultant Location:
Mostly Remote (Periodic Travel to Texas or California) Duration:
Approximately 5-7 months (to be confirmed) Client:
Regional Health Plan (Confidential) Rate:
$85 - $110 (Negotiable - based on candidate experience and location factors) Position Overview: We are seeking a highly skilled
Medicare Claims Integration Consultant
to support the implementation of a new claims processing platform for a regional health plan client in the Southwest. The ideal candidate will bring deep expertise in Medicare claims processing, system implementation, and business requirements definition, along with the ability to collaborate effectively with vendors and internal teams. This role will work closely with an engagement leader/project manager to ensure a successful delivery. Key Responsibilities: Lead and define
requirements
and
business logic
for the design and implementation of a new Medicare claims platform. Provide subject matter expertise on
Medicare claims processing , including compliance and operational best practices. Advise leadership and functional teams on
system design , technical solutions, and practical approaches to meet payer business needs. Identify and communicate the
critical path
for a successful claims implementation. Participate in and/or lead
design sessions, requirements workshops, and solution validation . Collaborate closely with
vendors
to ensure alignment on scope, timeline, and deliverables. Support or lead aspects of claims platform
system implementations or upgrades . Partner with the project engagement leader to track progress, manage dependencies, and drive resolution of issues. Qualifications: Proven experience in
Medicare claims processing
with a focus on implementation or integration projects. Strong track record in
requirements gathering, business logic definition, and solution design
for payer systems. Experience leading or supporting
claims platform implementations
or upgrades. Demonstrated ability to
collaborate with vendors
and manage cross-functional stakeholder relationships. Excellent communication, facilitation, and problem-solving skills. Willingness and ability to travel periodically to client sites in Texas or California. About INSPYR Solutions Technology is our focus and quality is our commitment. As a national expert in delivering flexible technology and talent solutions, we strategically align industry and technical expertise with our clients business objectives and cultural needs. Our solutions are tailored to each client and include a wide variety of professional services, project, and talent solutions. By always striving for excellence and focusing on the human aspect of our business, we work seamlessly with our talent and clients to match the right solutions to the right opportunities. Learn more about us at inspyrsolutions.com. Equal Opportunity Employer INSPYR Solutions provides Equal Employment Opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, INSPYR Solutions complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.
Seniority level
Seniority level
Mid-Senior level Employment type
Employment type
Contract Job function
Job function
Health Care Provider Industries
Business Consulting and Services Referrals increase your chances of interviewing at INSPYR Solutions by 2x Sign in to set job alerts for Claims Consultant roles.
Naperville, IL $84,000.00-$126,000.00 1 month ago Senior Claim Specialist, Casualty Claims
Chicago, IL $115,000.00-$140,000.00 1 week ago Chicago, IL $70,000.00-$80,000.00 5 days ago Chicago, IL $70,000.00-$85,000.00 2 weeks ago Naperville, IL $60,080.00-$126,000.00 1 month ago Chicago, IL $120,000.00-$145,000.00 1 week ago Downers Grove, IL $51,807.00-$83,551.00 1 month ago Downers Grove, IL $51,807.00-$83,551.00 2 days ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr
$85.00/hr - $110.00/hr Job Title:
Medicare Claims Integration Consultant Location:
Mostly Remote (Periodic Travel to Texas or California) Duration:
Approximately 5-7 months (to be confirmed) Client:
Regional Health Plan (Confidential) Rate:
$85 - $110 (Negotiable - based on candidate experience and location factors) Position Overview: We are seeking a highly skilled
Medicare Claims Integration Consultant
to support the implementation of a new claims processing platform for a regional health plan client in the Southwest. The ideal candidate will bring deep expertise in Medicare claims processing, system implementation, and business requirements definition, along with the ability to collaborate effectively with vendors and internal teams. This role will work closely with an engagement leader/project manager to ensure a successful delivery. Key Responsibilities: Lead and define
requirements
and
business logic
for the design and implementation of a new Medicare claims platform. Provide subject matter expertise on
Medicare claims processing , including compliance and operational best practices. Advise leadership and functional teams on
system design , technical solutions, and practical approaches to meet payer business needs. Identify and communicate the
critical path
for a successful claims implementation. Participate in and/or lead
design sessions, requirements workshops, and solution validation . Collaborate closely with
vendors
to ensure alignment on scope, timeline, and deliverables. Support or lead aspects of claims platform
system implementations or upgrades . Partner with the project engagement leader to track progress, manage dependencies, and drive resolution of issues. Qualifications: Proven experience in
Medicare claims processing
with a focus on implementation or integration projects. Strong track record in
requirements gathering, business logic definition, and solution design
for payer systems. Experience leading or supporting
claims platform implementations
or upgrades. Demonstrated ability to
collaborate with vendors
and manage cross-functional stakeholder relationships. Excellent communication, facilitation, and problem-solving skills. Willingness and ability to travel periodically to client sites in Texas or California. About INSPYR Solutions Technology is our focus and quality is our commitment. As a national expert in delivering flexible technology and talent solutions, we strategically align industry and technical expertise with our clients business objectives and cultural needs. Our solutions are tailored to each client and include a wide variety of professional services, project, and talent solutions. By always striving for excellence and focusing on the human aspect of our business, we work seamlessly with our talent and clients to match the right solutions to the right opportunities. Learn more about us at inspyrsolutions.com. Equal Opportunity Employer INSPYR Solutions provides Equal Employment Opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, INSPYR Solutions complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.
Seniority level
Seniority level
Mid-Senior level Employment type
Employment type
Contract Job function
Job function
Health Care Provider Industries
Business Consulting and Services Referrals increase your chances of interviewing at INSPYR Solutions by 2x Sign in to set job alerts for Claims Consultant roles.
Naperville, IL $84,000.00-$126,000.00 1 month ago Senior Claim Specialist, Casualty Claims
Chicago, IL $115,000.00-$140,000.00 1 week ago Chicago, IL $70,000.00-$80,000.00 5 days ago Chicago, IL $70,000.00-$85,000.00 2 weeks ago Naperville, IL $60,080.00-$126,000.00 1 month ago Chicago, IL $120,000.00-$145,000.00 1 week ago Downers Grove, IL $51,807.00-$83,551.00 1 month ago Downers Grove, IL $51,807.00-$83,551.00 2 days ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr