Claims Administration Manager

Careington International; Frisco (TX); On-site; USD 60,000 - 75,000; Full time

Job summary

Careington International is seeking a Claims Specialist to join our Frisco, TX corporate office 5 days a week. You will manage workload, update incidents and claims, and collaborate with cross-functional teams to ensure accurate, compliant claims processing.

The ideal candidate holds a Bachelor’s degree in Business or related field, 3+ years in claims, and strong MS Office skills, with a meticulous, independent work style and excellent written and verbal communication.

Qualifications

• Bachelor’s degree in Business or a related field is required.
• Minimum 3+ years of relevant experience in claims or a related field.
• Proficiency with Microsoft Office applications.

Responsibilities

• Manage the workload of the Claims Specialist.
• Continuously manage and update existing incidents and claims in the Careington database.
• Interact with external customers and vendors.
• Apprise management of escalated risk.
• Develop a strong team through training and effective organizational development practices.
• Manage and oversee end-to-end claims administration operations including escalation management.
• Act as an escalation point for complex or sensitive claims or customer issues.
• Ensure claims are handled accurately, efficiently, and in compliance with internal policies and applicable regulations.
• Partner with Claims leadership to align departmental goals, staffing models, and operational priorities.
• Collaborate cross-functionally with other departments such as the contact center to resolve issues and improve processes.
• Ensure all claim submissions meet quality control standards and internal documentation policies.

Skills

3+ Years experience in Claims

Bachelor’s degree in Business

Microsoft Office proficiency

Independent work style

Strong communication

Attention to detail

Education

Bachelor’s degree in Business or related field

Tools

Microsoft Office

Job description

For more than 45 years, Careington International has been a leader in the health and wellness benefits space. Since its founding in 1979, Careington has been delivering dental discount solutions as its core competency. Today, Careington has expanded to offer a growing portfolio of 150+ health, wellness, lifestyle and virtual health products and services designed to deliver cost savings across a spectrum of life needs. Through its affiliated nationally licensed third-party administrator (TPA), Careington also delivers full-scale administrative services, including customer service, licensed enrollment, claims administration, individual and group billing.

This role will be worked in office 5x a week in Frisco, TX at our corporate office.

Roles and Responsibilities:

• Manage the workload of the Claims Specialist.
• Continuously manage and update existing incidents and claims in the Careington database.
• Interact with external customers and vendors.
• Apprise management of escalated risk.
• Develop a strong team through training and effective organizational development practices.
• Manage and oversee end-to-end claims administration operations including escalation management.
• Act as an escalation point for complex or sensitive claims or customer issues.
• Ensure claims are handled accurately, efficiently, and in compliance with internal policies and applicable regulations.
• Partner with Claims leadership to align departmental goals, staffing models, and operational priorities.
• Collaborate cross-functionally with other departments such as the contact center to resolve issues and improve processes.
• Ensure all claim submissions meet quality control standards and internal documentation policies.

Qualifications and Skills:

Required

• Bachelor’s degree in Business or a related field.
• 3+ Years of relevant experience in Claims or a related field.
• Familiarity with Microsoft Office.

Preferred

• Prior experience in a highly regulated field such as insurance or finance.

Skills:

• Ability to work independently with a high level of accuracy.
• Strong organizational and project management skills.
• Excellent written and oral communication skills.
• High attention to detail and commitment to accuracy.

Equal Opportunity Employer
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