Director of Claims Operations & Automation

Gravie; United States; Remote; USD 180,000 - 280,000; Full time

Benefits offered by this job

401(k) program

Flexible PTO

Paid parental leave

Paid holidays

Job summary

Gravie is seeking a Director of Claims Operations to lead end-to-end claims lifecycle, including production processing, stop loss, support and appeals, and payments. You will manage a team of managers and individual contributors, drive process improvement and automation, and ensure regulatory and contractual compliance.

You will collaborate across Finance, HR, and VP Claims to set performance standards and staffing, while building a high-accountability culture and a focus on quality and timely

Qualifications

• Bachelor's degree or commensurate experience.
• 8+ years of healthcare claims operations experience.
• 3+ years of experience leading managers and teams.
• Strong knowledge of claims adjudication logic, stop loss mechanics, coordination of benefits, subrogation, and payment integrity fundamentals.
• Experience driving automation and process improvement in manual-heavy environments; familiarity with claims platforms and EDI workflows.

Responsibilities

• Lead end-to-end claims operations across production processing, stop loss, support and appeals, and payments.
• Manage a team of Claims Managers and a payments team; drive accountability and growth.
• Oversee automation initiatives and process improvements in claims operations.
• Ensure regulatory and contractual compliance; manage vendor relationships and performance.

Skills

Leadership

Claims Operations

Automation / Process Improvement

Vendor Management

Cross-functional Collaboration

Education

Bachelor's degree

Tools

EDI workflows

Claims platforms

Job description

Gravie is seeking a Director of Claims Operations to lead end-to-end claims lifecycle, including production processing, stop loss, support and appeals, and payments. You will manage a team of managers and individual contributors, drive process improvement and automation, and ensure regulatory and contractual compliance.

You will collaborate across Finance, HR, and VP Claims to set performance standards and staffing, while building a high-accountability culture and a focus on quality and timely