Manager Claims - LHB

Luminare Health Benefits Inc.; United States; Remote; USD 50.000 - 93.000; Vollzeit

Benefits dieser Stelle

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

Other incentives

Zusammenfassung

Luminare Health is seeking a Claim Manager to lead Claim Analysts and possibly outsourced staff, ensuring quality, production, and client commitments are met. The role emphasizes supervision, process improvement, and cross-team coordination.

The position supports remote work from within the continental United States and requires strong communication and leadership to guide teams and optimize claim processing and customer service.

Qualifikationen

• High School Diploma or GED required.
• 3–5 years claim processing experience.
• Previous supervisory or management experience.
• Self-directed with minimal supervision.
• Excellent verbal and written communication skills.
• Strong leadership, organizational and interpersonal skills.
• Ability to work with clients, providers, and colleagues at all levels.
• Proficient in MS Excel/Word.

Aufgaben

• Oversee day-to-day supervision of Claim Analysts or outsourced staff.
• Achieve team quality, production and service targets; support new client implementations.
• Mentor staff and ensure adherence to procedures and policies.
• Manage multiple Claim Units or vendor relationships as needed.

Kenntnisse

Verbal communication

Written communication

Leadership

Interpersonal skills

Problem solving

Self-directed

Team management

Client interaction

Ausbildung

High School Diploma or GED

Bachelor's degree

Tools

MS Excel

MS Word

Jobbeschreibung

At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success. We're committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable.

The 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

• 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.
• 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

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

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.

We are a drug‑free and smoke‑free workplace.

Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

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 for associates.

• 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
• Other incentives

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

Min to Max Range: $49,500.00 - $92,800.00 Exact compensation may vary based on skills, experience, and location.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug‑free and smoke‑free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to 'candidate home' to view your job submissions.