Claims Manager

Hawaii-Western Management Group Inc; Honolulu (HI); Sur place; USD 55 000 - 80 000; Plein temps

Résumé du poste

Hawaii-Western Management Group Inc in Honolulu seeks a Claims Manager to lead the Claims Department, ensuring targets for turnaround time, accuracy, and performance. This full-time role requires strong leadership and process discipline.

You will supervise staff, set policies, update health plans in the claims system, and generate reports to monitor productivity. Familiarity with industry regulations and strong communication skills are essential.

Qualifications

• High school diploma or GED required.
• Excellent organizational, analytical, and time management skills.
• Strong attention to detail and decision-making.
• Strong leadership, presentation, problem-solving, and communication skills.
• Proficiency in Microsoft Word and Excel (intermediate).

Responsabilités

• Oversees the operation of the Claims Department and meets targets for turnaround time and accuracy.
• Supervises department employees—hiring, training, coaching, and evaluating performance.
• Establishes department policies and procedures to ensure efficiency, accuracy, and compliance.
• Maintains and updates health plans in the claims system.
• Generates reports and monitors productivity and timelines.
• Keeps current with industry changes and their impact on claims processing.

Connaissances

Organizational skills

Analytical skills

Time management

Attention to detail

Decision-making

Leadership

Communication skills

Presentation skills

Problem-solving

Microsoft Word (intermediate)

Microsoft Excel (intermediate)

Formation

High school diploma or GED

College degree in Business Administration, Healthcare Management or related field

Outils

Microsoft Word

Microsoft Excel

Description du poste

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Claims Manager

Full Time Honolulu, HI, US

20 days ago Requisition ID: 1004

Salary Range: $55,000.00 To $80,000.00 Annually

Summary

• Oversees the operation of the Claims Department and ensures the department meets targets with respect to turnaround time, accuracy, and other benchmarks.
• Supervises department employees including hiring, training, coaching, and developing employees; assigning work; and evaluating performance.
• Establishes department policies and procedures including processing guidelines to ensure efficiency, accuracy, and consistency in accordance with Senior Management intent, Federal and State mandates, insurance industry standards, and plan documents.
• Maintains and updates health plans in the claims system.
• Updates the claims system after new edit releases and other updates.
• Generates system reports and oversees the preparation of daily, weekly, monthly, and other productivity reports to monitor claim processing standards and timelines and assist in workflow distribution.
• Keeps current with industry changes and how they affect claims processing.

Qualifications

Required

• High school diploma or GED
• Excellent organizational, analytical, and time management skills
• Strong attention to detail
• Strong decision-making, leadership, presentation, problem-solving, and oral and written communication skills
• Able to consistently meet deadlines
• Effectively present information in one-on-one and small group situations to customers, clients, Senior Management, and other employees of the Company
• Intermediate-level proficiency in Microsoft Word and Excel

Preferred

• College degree in Business Administration, Healthcare Management or related field; five years of experience in claims supervision or management or related experience; or equivalent combination of education and experience
• Proficient in medical terminology, medical billing, and medical coding
• Thorough knowledge of claims administration, regulations, and processing systems

Starting Salary Range: $55,000 - $80,000. Full salary range is broader and depends on experience.