Manager Claims - LHB

Davita Inc.; United States; Remote; USD 48,000 - 91,000; Full time

Job summary

A leading company in healthcare is seeking a Claim Manager to oversee day-to-day operations of their claims department. The role involves supervising a team, ensuring quality and service expectations are met, and managing client relationships effectively. Ideal candidates will have strong leadership skills, relevant experience in claim processing, and the ability to communicate effectively with various stakeholders.

Benefits

401(k) savings plan

Paid time off

Paid parental leave

Disability insurance

Employee assistance program

Tuition reimbursement

Qualifications

• 3-5 years claim processing experience.
• Previous supervisory or management experience required.
• Ability to learn new/proprietary systems.

Responsibilities

• Supervise a team of Claim Analysts and outsourced staff.
• Ensure achievement of team quality and production expectations.
• Answer complex claim and customer service questions.

Skills

Self-directed

Excellent verbal and written communication

Leadership

Organizational skills

Interpersonal skills

Problem resolution

Adaptability

Microsoft Excel

Microsoft Word

Education

High School Diploma or GED

Bachelor's degree

Job description

At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job SummaryThe Claim Manager is responsible for the day-to-day supervision and management of a team, or multiple teams, of Luminare Health Claim Analysts and/or outsourced vendor staff enabling the department to meet its client and corporate commitments. Responsibilities include, but are not limited to, successful achievement of team quality, production and service expectations, staff development, successful implementation of new clients into the Unit, and retention of existing clients. The Manager is responsible for answering complex or difficult claim or customer service questions, advising team members regarding claim processing or customer service procedures, and providing support to ensure all department goals are met. The Manager is expected to have greater visibility and accountability than a Claim Supervisor. This may involve responsibility for multiple Claim Units, each with its own Supervisor, a Claim Unit with more complex or visible clients, and/or management of an outsourced vendor relationship.

Required Job Qualifications:

• High School Diploma or GED equivalent
• 3-5 years claim processing experience
• Previous supervisory or management experience
• Self-directed individual who works well with minimal supervision
• Excellent verbal and written communication skills
• Strong leadership, organizational and interpersonal skills
• Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
• Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
• Ability to effectively deal with problems in varying situations and reach resolution
• Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
• Flexible; open to continued process improvement
• Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word

Preferred Job Qualifications:

• Bachelor's degree
• Self-Funded Insurance/Benefits and/or TPA experience

Please note this is a Telecommute (Remote role). Candidates must live within the following states: IL, IN, IA, KS, MO, MT, NM, NC, OK, PA, TN, TX or WI. Sponsorship is not available.

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EEO Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Pay Transparency Statement:

At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan,pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package forassociates.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

Min to Max Range:

$48,500.00 - $91,000.00