Manager, Claims

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and lead a team or multiple teams of Luminare Health Claim Analysts and/or external vendor personnel.

• Ensure that team quality, production, and service targets are met.

• Foster staff development.

• Integrate new clients into the Unit.

• Maintain relationships with existing clients.

• Respond to complex or challenging claim or customer service inquiries.

• Guide team members on claim processing and customer service protocols.

• Offer support to guarantee that departmental objectives are achieved.

• Manage several Claim Units, intricate or prominent clients, and/or external vendor partnerships as necessary.

⛳️ Requirements

• High School Diploma or equivalent GED.

• 3-5 years of experience in claim processing.

• Prior experience in a supervisory or management role.

• Self-motivated individual capable of working independently with minimal oversight.

• Exceptional verbal and written communication abilities.

• Strong leadership, organizational, and interpersonal skills.

• Capability to work effectively with employees/members, providers, clients, and various levels of colleagues including Client Managers and staff at all levels.

• Ability to apply common sense and understanding to execute instructions provided in oral, written, or diagrammatic form.

• Competence in addressing issues in diverse situations and achieving resolutions.

• Proficient in reading, analyzing, and interpreting documents and Summary Plan Descriptions (SPDs).

• Adaptable and open to ongoing process enhancements.

• Capacity to learn new/proprietary systems, adjust to different system platforms, and utilize MS Excel/Word effectively.

• Preferred: Bachelor’s degree.

• Preferred: Experience in Self-Funded Insurance/Benefits and/or TPA.

🏝️ Benefits

• Health and wellness benefits.

• 401(k) savings plan.

• Pension plan.

• Paid time off.

• Paid parental leave.

• Disability insurance.

• Supplemental life insurance.

• Employee assistance program.

• Paid holidays.

• Tuition reimbursement.

• Additional incentives.

• Annual incentive bonus plan subject to the plan's terms and conditions.

• Remote work opportunity from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.