Manager, Claim Processing

This is a fully remote position, open to applicants in New York, +3 more states.

📋 Description

• Oversees the daily operations of the team by providing strategic direction and managing the claims processing team(s).

• Directs workflow to guarantee the efficient and precise processing of medical claims by establishing and monitoring productivity and quality metrics.

• Resolves intricate or escalated claims issues, offering guidance to claim processors in managing difficult cases.

• Develops quality control processes to ensure the accuracy and uniformity of claim processing.

• Aids in the formulation of the claim processing budget by tracking expenses and identifying opportunities for cost reduction.

• Examines claim processing data and produces reports to monitor and assess key performance metrics.

• Works collaboratively with other departments to ensure effective communication and coordination within the claim processing workflow.

• Ensures adherence to industry regulations and company policies.

⛳️ Requirements

• 5–7 years of experience in healthcare claims and/or operations.

• 5–7 years of proven leadership experience, including oversight of teams and performance management.

• Strong capabilities in execution and delivery, encompassing planning, implementation, and ongoing support.

• Excellent problem-solving and decision-making skills in complex environments.

• Demonstrated ability to collaborate effectively across teams and establish strong partnerships with diverse stakeholders.

• Displays a growth mindset, characterized by adaptability, continuous learning, and the capacity to develop oneself and others.

• Strong written and verbal communication skills.

• Certified Billing and Coding Specialist (CBCS) is preferred.

• Preference for candidates located on the East Coast.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Comprehensive benefits package based on eligibility.