Manager, Claims

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

📋 Description

• Oversee and lead one or more teams of Luminare Health Claim Analysts and/or outsourced vendor personnel.

• Ensure that quality, production, and service expectations for the team are consistently met.

• Foster the development of staff members.

• Successfully onboard new clients into the Unit.

• Maintain relationships with existing clients.

• Address complex or challenging claims and customer service inquiries.

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

• Provide assistance to ensure departmental objectives are achieved.

• Manage several Claim Units, including complex or highly visible clients, and/or outsourced vendor partnerships as needed.

⛳️ 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.

• Outstanding verbal and written communication abilities.

• Strong leadership, organizational, and interpersonal skills.

• Capability to engage effectively with employees/members, providers, clients, Client Managers, and all levels of staff.

• Aptitude for using common sense understanding to execute oral, written, or diagrammatic instructions.

• Ability to address problems in varying scenarios and reach resolutions.

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

• Open and adaptable to ongoing process improvements.

• Ability to learn new/proprietary systems and adjust to various system platforms.

• Effective use of MS Excel and Word.

• Preferred: Bachelor's degree.

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

🏝️ Benefits

• Thoughtful development opportunities.

• 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.

• Other incentives.

• Annual incentive bonus plan, subject to the terms and conditions of the plan.