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 staff from outsourced vendors.

• Ensure that the team's quality, production, and service goals are met.

• Foster staff development.

• Integrate new clients into the Unit.

• Maintain relationships with existing clients.

• Address complex or challenging claims or customer service inquiries.

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

• Offer support to achieve all departmental objectives.

• Manage several Claim Units, high-profile clients, and/or relationships with outsourced vendors as required.

⛳️ Requirements

• High School Diploma or GED equivalent.

• 3-5 years of experience in claim processing.

• Prior supervisory or management experience.

• A self-motivated individual who operates effectively with minimal supervision.

• Exceptional verbal and written communication skills.

• Strong leadership, organizational, and interpersonal abilities.

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

• Ability to utilize common sense understanding to follow instructions provided in oral, written, or diagrammatic form.

• Proficient in resolving issues across diverse situations.

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

• Open-minded and adaptable to ongoing process improvements.

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

• Bachelor’s degree is preferred.

• Experience in Self-Funded Insurance/Benefits and/or TPA is preferred.

🏝️ 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 terms and conditions of the plan.

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