Claims Operations Leader — Drive Accuracy & Efficiency

Express Employment Professionals - Cincinnati East; Honolulu (HI); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Paid holidays (floating & birthday)

Paid vacation

Sick leave

401k with company match 25%

Job summary

Express Employment Professionals - Cincinnati East is seeking a Claims Manager to lead a busy Honolulu-based Claims Department. You will oversee daily processing, ensure accuracy and turnaround, and develop staff in a fast-paced, regulated environment.

The role requires hands-on leadership, strong claims knowledge, and the ability to implement process improvements while managing reporting and systems updates.

Qualifications

• High school diploma or GED required.
• Supervisory/leadership experience preferred.
• Knowledge of claims administration, regulations, and systems.
• Excellent leadership and problem-solving skills.
• Strong organizational, analytical, and time-management abilities.
• Attention to detail and ability to meet deadlines.
• Professional written, verbal, and presentation skills.
• Knowledge of medical terminology, billing, and coding preferred.
• College degree in Business Administration or Healthcare Management preferred.

Responsibilities

• Oversee daily claims processing operations and departmental workflow.
• Ensure accuracy, efficiency, and turnaround standards are consistently met.
• Hire, train, coach, and develop Claims Department employees.
• Assign work, evaluate performance, and support employee development.
• Establish and maintain claims processing policies, procedures, and guidelines.
• Maintain and update health plans within the claims processing system.
• Coordinate system updates, new edits, fee schedules, and coding changes.
• Generate and review productivity and performance reports.
• Monitor processing standards, timelines, and workflow distribution.
• Stay current on industry regulations and changes affecting claims processing.

Skills

Leadership

Claims knowledge

Regulatory knowledge

Analytical skills

Time management

Communication

MS Word

MS Excel

Education

High school diploma or GED

Bachelor’s degree preferred

Tools

MS Word

MS Excel

Job description

Express Employment Professionals - Cincinnati East is seeking a Claims Manager to lead a busy Honolulu-based Claims Department. You will oversee daily processing, ensure accuracy and turnaround, and develop staff in a fast-paced, regulated environment.

The role requires hands-on leadership, strong claims knowledge, and the ability to implement process improvements while managing reporting and systems updates.