Remote Claims Manager — Lead Claims Ops & Patient Care

Avesis Incorporated; United States; Remote; USD 80,000 - 134,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) with company match

Tuition assistance

Paid parental leave

Flexible time off

Job summary

Avēsis is seeking a Manager of Claims to oversee Claims Supervisors, processing staff and claims technology initiatives, ensuring timely and accurate payments in line with contractual requirements.

You will lead workflow optimization, monitor performance, present analytics to the executive leadership team, conduct annual reviews and support audits, while coordinating cross‑functional improvement projects in a remote-friendly environment across time zones.

Qualifications

• Minimum 5 years supervisory or management experience leading a production team.
• 3+ years’ experience leading or participating in claim enhancements, auto-adjudication triggers; robotic process automation and claims adjudication system logic.
• Knowledge of Medicare, Medicaid, and/or Commercial insurance terminology and high-level claims payment processes.
• Advanced in Microsoft Office products, including Excel, Word, and other Windows-based tools used to aggregate, analyze, trend and report.
• Ability to work flexible hours to accommodate business needs in all time zones.

Responsibilities

• Oversight of Claims Supervisors and processing staff; workflow management and annual reviews.
• Develop and monitor performance metrics; ensure timely processing within contractual time frames.
• Present data, analysis and improvement plans to the Claims Executive Leadership Team.
• Interview, hire, and onboard applicants for Claims department positions.
• Lead process improvement projects and assist audits and policy updates.

Skills

Leadership

Communication

Attention to detail

Problem solving

Time management

Education

Bachelor's degree or equivalent

Tools

Microsoft Office

Job description

Avēsis is seeking a Manager of Claims to oversee Claims Supervisors, processing staff and claims technology initiatives, ensuring timely and accurate payments in line with contractual requirements.

You will lead workflow optimization, monitor performance, present analytics to the executive leadership team, conduct annual reviews and support audits, while coordinating cross‑functional improvement projects in a remote-friendly environment across time zones.