Manager Claim Processing

• Manages day-to-day of team by providing strategic leadership and overseeing the operations of the claims processing team(s)
• Directs workflow to ensure the efficient and accurate processing of medical claims by establishing and monitoring productivity and quality metrics
• Implements and maintains quality control processes to ensure accuracy and consistency in claim processing
• Advises team members in resolving complex or escalated claims issues by providing guidance on claim handling procedures, policy interpretation, and compliance with industry regulations
• Analyzes key performance indicators (KPIs) to assess the productivity and quality of the claims department and prepares regular performance reports for management
• Streamlines and improves claim processing procedures by collaborating with cross-functional teams to implement process enhancements, automation, and system upgrades to increase efficiency and accuracy
• Ensures consistent compliance with applicable laws, regulations, and industry standards related to claims processing
• Assists management in the development of the department's budget by monitoring expenses, analyzing budget variances, and recommending cost-saving measures while ensuring operational effectiveness and maintaining service quality
• Establishes a positive work environment, encouraging professional development, and addressing any performance issues
• Directs tasks and responsibilities to team members, ensuring the claim workload distribution is equitable and efficient

• 3-5 leadership/management experience
• Must be proficient in Word, Excel, and Microsoft Office
• Ability to collaborate and work as a team
• Ability to execute a plan and deliver (planning, delivering, and supporting)
• Ability to solve problems and make sound business decisions
• Adept at growth mindset (agility and developing yourself and mentor others)
• 3-5 years insurance claims processing experience (preferred)
• Bachelor's degree preferred or a combination of professional work experience and education

3-5 years insurance claims processing experience

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access