Claims Configuration Senior Manager

Ladders; United States; Remote; USD 111,000 - 150,000; Full time

Benefits offered by this job

Health plan

Dental plan

Vision plan

Paid time off

Mobile stipend

Stock options

Bonus eligibility

Parental leave

401K

Job summary

Ladders is seeking a Claims Configuration Senior Manager to join its team, focusing on critical claims configuration processes that influence payment accuracy, efficiency, and member/provider experience. This role acts as SME on complex claims logic across operations and tech stakeholders to improve automation and resolve issues. Location: Remote.

Compensation: $110,500 – $150,000 annually. The role measures performance, identifies root causes, and drives sustainable improvements in a highly

Qualifications

• 6+ years of experience in business operations or operational leadership.
• Comfort with ambiguity and deep understanding of complex claims system logic.
• Exceptional communication skills for both technical and non-technical audiences.
• Proven track record of driving change and measurable results in fast-paced environments.
• Strong analytical skills with experience in KPI development and large dataset analysis.
• Ability to thrive in a metrics-driven environment while managing multiple initiatives.

Responsibilities

• Own the auto-adjudication rate and evaluate flags for manual review.
• Serve as the expert on claims matching to provider contracts.
• Ensure accuracy of member EOBs and provider EOPs.
• Support remittance outputs and resolve processing issues.
• Identify errors and lead root cause analysis for sustainable fixes.
• Establish performance measurement frameworks for claims logic.
• Recommend improvements based on regulatory changes and emerging technology.

Skills

6+ years of experience in business ops

Ambiguity tolerance

Exceptional communication

Change leadership

Analytical skills with KPI

Multitasking in fast-paced env

Job description

For our client, we are seeking a Claims Configuration Senior Manager to join the team of a leader in the Hospitals & Medical Centers space.

This role will own critical claims configuration processes that influence payment accuracy, operational efficiency, and the member and provider experience. You will serve as a key subject matter expert on complex claims logic, working across operations and technical stakeholders to improve automation, resolve processing issues, and strengthen controls. The position also plays an important role in measuring performance, identifying root causes, and driving sustainable improvements in a highly regulated healthcare environment.

Location: Remote

Compensation: $110,500 – $150,000 annually

Responsibilities

• Own the auto-adjudication rate and evaluate flags for manual review
• Serve as the expert on claims matching to provider contracts
• Ensure accuracy of member EOBs and provider EOPs
• Support remittance outputs and resolve processing issues
• Identify errors and lead root cause analysis for sustainable fixes
• Establish performance measurement frameworks for claims logic
• Recommend improvements based on regulatory changes and emerging technology

Qualifications

• 6+ years of experience in business operations or operational leadership
• Comfort with ambiguity and deep understanding of complex claims system logic
• Exceptional communication skills for both technical and non-technical audiences
• Proven track record of driving change and measurable results in fast-paced environments
• Strong analytical skills with experience in KPI development and large dataset analysis
• Ability to thrive in a metrics-driven environment while managing multiple initiatives

Benefits

• Employer sponsored health, dental, and vision plans with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director level and above
• Parental leave program
• 401K program
• And more

Our client is an equal opportunity employer. We encourage you to apply even if you don’t meet every qualification—your background could be exactly what this team needs.