Claims Manager

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Oversee claims, analysis, and enrollment operations.

• Take responsibility for team performance, data accuracy, and compliance.

• Manage claims processing, reporting, and reimbursement efforts.

• Facilitate cross-functional collaboration to ensure precise claims payments and operational efficiency.

• Supervise daily operations of claims, analysis, and enrollment teams.

• Lead claims adjudication, reconciliation, auditing, and reporting processes.

• Evaluate claims data to uncover trends, risks, and areas for enhancement.

• Oversee the creation and upkeep of reimbursement tables and processes.

• Direct staff performance, development, and accountability.

⛳️ Requirements

• Associate's degree with three (3) years of experience in claims filing and data reporting or eligibility and enrollment processes; OR a Bachelor's degree with one (1) year of experience in these areas; OR a suitable combination of education and experience.

• A valid driver’s license is required.

• Candidates must reside in North Carolina.

• Ability to travel within the designated area as needed.

• Preferred: An advanced degree.

• Preferred: Supervisory experience with two (2) or more employees.

• Preferred: Experience with Physical Health claims.

• All applicants must successfully pass a drug test as a condition of employment.

🏝️ Benefits

• Collaborative, mission-driven work environment.

• Competitive benefits package.

• Work-from-home options available for most positions.

• Flexible work schedules for some roles, subject to management approval.

• Health Insurance with no premium for employee coverage.

• Flexible Spending Accounts.

• 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year.

• NC Local Government Retirement Pension (defined-benefit plan).

• 401k with a 5% employer match and immediate vesting.

• Qualifying employer for Public Service Loan Forgiveness (PSLF).

• Quarterly stipend for remote work supplies.