About TruHearing

TruHearing is a rewarding, fun and friendly, mission-based organization that makes a real difference towards improving people’s lives. It’s not just HR saying this: employees have spoken and have voted TruHearing as one of Utah’s Top Workplaces! Our employees enjoy a positive working environment in a company that has experienced rapid growth. We offer a comprehensive benefits package, educational assistance, and opportunities for advancement.

TruHearing is the market leader and a force for positive change in the hearing healthcare industry. We reconnect people to the richness of life through industry-leading hearing healthcare solutions. We work with insurance companies, hearing aid manufacturers, and healthcare providers to reduce prices and expand access to better hearing care and whole-body health.

TruHearing is part of the WS Audiology Group (WSA), a global leader in the hearing aid industry. Together with our 12,000 colleagues in 130 countries, we invite you to help unlock human potential by bringing back hearing for millions of people around the world. The WSA portfolio of technologies spans the full spectrum of hearing care, from distinct hearing brands and digital platforms to managed care, hearing centers and diagnostics locations.

About the Opportunity:

This role exists to provide strategic and operational leadership over insurance operations, medical claims, and the revenue lifecycle to ensure accurate, compliant, and efficient claims processing while optimizing reimbursement, minimizing revenue leakage, and supporting the organization’s financial and growth objectives.

What will you be doing?

Insurance Operations & Revenue Leadership

• Provide executive leadership for insurance operations, medical claims adjudication, and the full revenue lifecycle, ensuring accurate, compliant, and efficient end-to-end processing.
• Serve as the primary subject matter expert for claims submission to payer partners and for claims adjudicated by TruHearing as a payer, with emphasis on regulatory compliance and reimbursement integrity.
• Establish and enforce operational standards, Service Level Agreements (SLAs), and Key Performance Indicators (KPIs) across claims and revenue cycle functions.
• Design and oversee claims and revenue processes that meet federal and state regulations, contractual requirements, and third-party audit standards.
• Act as an enterprise resource and advisor to executive and cross-functional teams on insurance operations, medical claims, and revenue cycle matters across commercial and government lines of business.

Revenue Cycle Performance & Financial Optimization

• Set and execute the strategic direction for revenue cycle management, overseeing end-to-end activities including claims submission, payment accuracy, denials management, appeals, and recoveries.
• Drive revenue optimization by reducing revenue leakage, improving clean claims and first-pass rates, and increasing denial appeal and underpayment recovery success.
• Partner cross-functionally to align claims operations with reimbursement models, reserve accuracy, and financial performance goals.
• Use operational and financial analytics to identify risk, variance, and opportunity across the claims and revenue lifecycle.
• Ensure claims and revenue outcomes support organizational growth, scalability, and value-based or delegated care models.

Insurance & Regulatory Compliance

• Provide executive oversight and accountability for compliance with all applicable federal and state regulations governing insurance operations, medical claims, and revenue cycle activities, including CMS, state Departments of Insurance (DOI), and delegated entity requirements.
• Ensure claims adjudication and revenue cycle processes consistently adhere to contractual, regulatory, and accreditation standards across commercial and government lines of business.
• Establish and sustain department readiness for internal audits, external audits, regulatory examinations, and partner reviews by maintaining strong controls, documentation, and corrective action processes.
• Partner with Legal and Compliance teams to identify, assess, and mitigate operational, financial, and regulatory risk related to claims processing and reimbursement.
• Oversee the development, implementation, and enforcement of policies and procedures that support compliance, auditability, and consistent execution across insurance and revenue functions.
• Monitor regulatory changes and industry guidance, translating requirements into operational practices and system configurations as needed.
• Ensure timely and accurate regulatory reporting, issue remediation, and corrective action plan execution when findings occur.

Team, Vendor, & Stakeholder Leadership

• Build, lead, and develop high-performing teams through clear expectations, regular 1:1s, coaching, and performance management.
• Establish scalable organizational structures and succession planning to support growth and operational continuity.
• Manage and optimize relationships with external vendors, payor partners, and delegated entities to ensure performance, compliance, and accountability.
• Foster a culture of ownership, continuous improvement, and service excellence across insurance operations and revenue teams.

Technology Enablement & Data Driven Execution

• Select, implement, and optimize claims and revenue cycle technologies to improve efficiency, accuracy, compliance, and scalability.
• Partner with IT and vendors to enhance system configuration, automation, and integration across claims and reimbursement workflows.
• Establish dashboards and executive reporting to monitor claims performance, revenue cycle health, compliance metrics, and financial impact.
• Ensure data integrity and reporting readiness for audits, regulatory submissions, and financial close processes.

What skills do you need to bring?

In addition to exhibiting the TruHearing Values of Going Beyond Together, Pioneering for Better Solutions, and Passion for Impact, this role requires the following:

1. Subject Matter Expertise: Develops new approaches and methods in their area of expertise. Is recognized as an expert within the organization and beyond.
2. Customer Focus: Ensures continued service excellence by establishing enterprise-wide solutions and methods, builds strong internal relationships.
3. Strategic Thinking: Manages macro-strategic issues that impact the entire organization.
4. Problem Solving: Solves broad, highly complex problems, or mitigates their impacts on the organization.
5. Planning & Organizing: Plans and organizes at a strategic, highly-impactful level.
6. Initiative: Seizes opportunities to enhance organizational performance in the short and long-term.
7. Productivity: Sets performance standards for the team or organization.
8. Resilience: Creates a positive environment and assists others in dealing with ongoing strenuous demands.
9. Agility: Guides others to prepare for and respond to changes with quick and focused actions.
10. Managing People: Builds and manages business divisions, a manager of managers.

What education or experience is required?

Required:

• Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or a related field and ten (10+) years of experience in insurance operations, medical claims, revenue cycle management, or related healthcare financial operations.
  • A combination of education and experience will be considered in lieu of a formal degree.
• Five (5+) years of executive or senior leadership experience overseeing complex, multifunctional teams within a payer, TPA, provider-sponsored health plan, or risk-bearing healthcare organization.
• Demonstrated expertise in medical claims adjudication, reimbursement methodologies, and end-to-end revenue cycle management, including denials management, appeals, and recovery processes.
• Deep working knowledge of federal and state insurance regulations, CMS requirements, delegated entity oversight, and audit preparedness.
• Proven track record of driving operational excellence, financial optimization, and process transformation at scale.
• Experience partnering with Finance, Actuarial, Medical Management, Compliance, and Technology teams to align operational performance with financial and regulatory outcomes.
• Familiarity with largescale claims and revenue cycle operational systems and platforms, such as QNXT, TriZetto, Waystar, and Availity

Preferred:

• Master’s degree (MBA, MHA, MPH, or equivalent).
• Experience managing vendor relationships, payer partnerships, and third-party administrators.
• Start-up or early-stage high-growth company experience especially in the healthcare benefits space.

Ancillary benefits claims adjudication.

What benefits are offered?

TruHearing offers a generous compensation and benefits package including health coverage, a fully vested 401k match, education assistance, fully paid long and short-term disability, paid time off and paid holidays. We are conveniently located across the street from the Draper FrontRunner station and subsidize the cost of a UTA pass with access to FrontRunner, TRAX and regular bus service – employee cost is less than $2 per day. You’ll work in an exciting and fun environment and have the opportunity to grow with us.

Equal Opportunity

TruHearing is an Equal Opportunity Employer who encourages diversity in the workplace. All qualified applicants will receive consideration for employment without regards to race, color, national origin, religion, sex, age, disability, citizenship, marital status, sexual orientation, gender identity, military or protected veteran status, or any other characteristic protected by applicable law.