Remote Claims Leader - Healthcare Quality

MagnaCare; United States; À distance; USD 120 000 - 170 000; Plein temps

Résumé du poste

MagnaCare is seeking a remote Claims Manager to lead our claims team and drive performance, accuracy, and service excellence across all workflows. You will coach, develop, and coach staff, oversee daily operations, and partner with providers and clients to deliver value.

The ideal candidate has 5+ years in leadership within healthcare claims, strong analytical and communication skills, and a track record of process improvements. Some travel to Las Vegas may be required.

Qualifications

• 5+ years of leadership experience in a claims setting.
• 5+ years of advanced healthcare claims adjudication experience.
• Strong Microsoft Office proficiency (Word & Excel).
• Excellent written and verbal communication and negotiation skills.
• Excellent analytical and problem-solving abilities.
• Strong time-management and prioritization in fast-paced environments.
• Ability to build positive relationships with clients, providers, members, and vendors.
• Bachelor’s degree preferred; equivalent healthcare claims experience considered.
• Bilingual skills preferred.

Responsabilités

• Lead and develop remote claims teams with focus on performance.
• Oversee daily claims operations, workload, productivity, and quality.
• Provide guidance to claims, vendors, and partners.
• Analyze performance trends and implement process improvements.
• Manage escalated issues and high-value adjustments.
• Conduct audits, performance evaluations, and attendance management.
• Develop training and onboarding for new hires and vendors.

Connaissances

Leadership

Communication

Time management

Analytical thinking

Relationship building

Adaptability

Negotiation

Formation

Bachelor’s degree or equivalent experience

Outils

Microsoft Office

Excel

Word

Description du poste

MagnaCare is seeking a remote Claims Manager to lead our claims team and drive performance, accuracy, and service excellence across all workflows. You will coach, develop, and coach staff, oversee daily operations, and partner with providers and clients to deliver value.

The ideal candidate has 5+ years in leadership within healthcare claims, strong analytical and communication skills, and a track record of process improvements. Some travel to Las Vegas may be required.