Claims Processing Manager: Drive Quality, Speed & Member Experience

Allied Benefit Systems; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

Allied Benefit Systems seeks a Manager of Claims Processing to lead teams ensuring accurate and timely claim processing in alignment with client SLAs, plan provisions, and regulatory standards. The role drives performance across inventories, networks, and multiple products, focusing on service excellence and audit readiness.

Responsibilities include coaching staff, managing escalations, and collaborating with stakeholders to improve workflows and member experience.

Qualifications

• Bachelor's degree or equivalent work experience required.
• Minimum 5 years of medical claims analysis and adjudication experience, including dental and vision.

Responsibilities

• Lead teams to ensure claims processing aligns with SLAs, plan documents, and regulatory standards.
• Monitor inventory, productivity, and quality to ensure timely, accurate claims handling.
• Oversee networks, products, and client performance requirements with focus on service excellence and audit readiness.
• Coach and develop staff; conduct performance reviews and talent development.
• Collaborate with stakeholders to resolve escalated client issues and streamline workflows.

Skills

Leadership

Claims analysis

Communication

Time management

Problem solving

Coaching

Cross-functional collaboration

Education

Bachelor's degree

Tools

Claims Management Systems

Job description

Allied Benefit Systems seeks a Manager of Claims Processing to lead teams ensuring accurate and timely claim processing in alignment with client SLAs, plan provisions, and regulatory standards. The role drives performance across inventories, networks, and multiple products, focusing on service excellence and audit readiness.

Responsibilities include coaching staff, managing escalations, and collaborating with stakeholders to improve workflows and member experience.