Lead, Medicare Payments Recovery

• →Strong analytical skills with the ability to perform detailed, manual case review
• →Claims and billing data analysis
• →Revenue tracking and reporting
• →Process documentation and workflow design
• →Stakeholder coordination and client communication
• →High attention to detail
• →Ability to track, report, and reconcile member and revenue data
• →Strong written communication and documentation skills

• Experience producing structured, auditable documentation and reports
• Experience working in healthcare data, revenue operations, or regulatory validation environments
• Demonstrated experience working with complex eligibility, coverage, and payment data
• Comfort working in highly governed environments and familiarity with healthcare compliance and audit standards
• Experience in Medicare Secondary Payer (MSP), payment integrity, benefits coordination, or claims recovery
• Experience with CMS data, Medicare recovery processes, or healthcare overpayment recovery
• Background in payment integrity, revenue recovery, or benefits administration

CAQH is the trusted data connector at the core of healthcare. For more than 25 years, we have powered the industry with the largest and most complete healthcare data foundation in the U.S., including more than 4.8 million provider data records sourced directly from providers and member data representing 75% of covered lives supplied by health plans. By improving how essential information flows across the system, CAQH helps healthcare operate more efficiently, accurately, and with greater confidence.

At CAQH, you will do meaningful work at the intersection of healthcare, data, and technology, helping solve complex problems that make the healthcare system work better. You will collaborate with experienced professionals who care deeply about accuracy, trust, and meaningful impact in a fully remote environment.

CAQH offers competitive compensation and a comprehensive benefits package for full-time employees, including medical, dental, and vision coverage, a 401(k) with company contributions and matching, paid parental leave, tuition assistance, and generous paid time off. We are committed to investing in our people and supporting professional growth over time.

CAQH is proud to be an equal opportunity employer and is committed to fostering a workplace where all individuals are valued, respected, and empowered.

Employment decisions at CAQH are made without regard to race, color, religion, sex, national origin or ancestry, age, marital status, disability, protected veteran status, personal appearance, sexual orientation, gender identity or expression, familial status, family responsibilities, matriculation, political affiliation, genetic information, source of income, place of residence, or any other characteristic protected by law. CAQH does not tolerate unlawful discrimination or harassment of any kind.

Applicants have rights under the Family and Medical Leave Act (FMLA), Equal Employment Opportunity (EEO), and the Employee Polygraph Protection Act (EPPA). If you need a reasonable accommodation to apply for a posted position, please contact the CAQH People & Culture team at Careers@caqh.org or 202-517-0436.