Manager Claims - LHB

Luminare Health; United States; Remote; USD 50,000 - 93,000; Full time

Job summary

The Claim Manager at Luminare Health will lead day-to-day supervision of a team of Claim Analysts and outsourced staff, ensuring quality, production and service targets are met.

You will develop staff, implement new clients into the unit, and maintain strong client relationships while handling complex claim questions and process improvements.

Qualifications

• 3–5 years claim processing experience.
• Previous supervisory or management experience.
• Excellent verbal and written communication skills.
• Ability to work with employees/members, providers and clients at various levels.
• Strong leadership, organizational and interpersonal skills.

Responsibilities

• Oversee day-to-day supervision of Claim Analysts and outsourced staff.
• Ensure team meets quality, production and service targets.
• Develop staff and implement new clients into the unit.
• Guide complex claim or customer service questions and provide support to meet goals.
• Coordinate with clients and internal teams to optimize processes.

Skills

Claim processing

Supervisory experience

Communication skills

Leadership

MS Excel/Word

Education

High School Diploma or GED

Bachelor's degree

Tools

MS Excel/Word

Job description

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.

Job Summary

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 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

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

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

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. 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.

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.