Claims Administration Manager - Medical Health Insurance Exp Req

Claims Administration Manager

Company

We have over 30 years of experience in managing integrative healthcare benefits and our smart solutions can deliver health results for you and your members! We focus on TPA services/ alternative care like Chiropractic, Acupuncture, Massage, and Naturopathic and our adjudicated rate is 94%. We deal with a limited amount of CPT codes as we do not do inpatient or outpatient services, surgeries, DME, PT/ OT, pharmacy, mental health, or Medicaid. 

Position Overview
Our company is seeking an experienced Claims Administration Manager to oversee the day-to-day operations of our medical health insurance claims department. The successful candidate will be responsible for ensuring efficient and accurate processing of claims while maintaining high levels of customer satisfaction. We are seeking someone with experience working with a Medical Health Insurance Carrier, Plan Provider, or TPA like Blue Cross, Providence, Kaiser, etc. 

Key Responsibilities

• Manage a team of claims professionals, including claims managers, supervisors, and processors
• Develop and implement policies and procedures to ensure timely and accurate claims processing
• Collaborate with other departments to identify and resolve issues related to claims processing
• Ensure compliance with all federal and state regulations related to claims processing
• Track and analyze claims data to identify trends and areas for improvement
• Provide training and development opportunities to claims staff
• Oversee the recruiting and hiring of new claims staff
• Conduct performance reviews and provide feedback to claims staff
• This is a Hybrid role requiring 2- 3 weeks in office during training, then 1 day a week in office. If out of state you will be required to be in office at least once a month (Expenses paid by us).

Qualifications

• Bachelor's degree in healthcare administration or a related field
• 5+ years of experience working in medical health insurance claims administration
• Experience working with medical health insurance carriers, TPAs, and care plan providers
• Strong leadership and management skills
• Excellent communication and interpersonal skills
• Experience with claims management software
• Nice to have skills: Claims Manager, Claims Supervisor, Claims Processing, Training, Recruiting, Performance Review

Benefits

Vacation/PTO

Medical

Dental

Vision

401k

Bonus

Relocation

Telecommute

Applicants must be authorized to work in the U.S.