Remote Claims Manager: Lead, Elevate Quality & Efficiency

MagnaCare; Oregon; Hybrid; USD 90,000 - 130,000; Full time

Job summary

Magnacare LLC is seeking a Claims Manager to lead remote claims teams and drive performance and quality. The role requires strong leadership, strategic oversight, and collaboration with cross-functional partners to optimize workflows.

The position involves occasional travel to Las Vegas, NV for business needs and may require navigating unionized environments while maintaining service excellence for clients and members.

Qualifications

• 5+ years of leadership experience leading remote or hybrid teams in a claims environment.
• 5+ years of advanced healthcare claims adjudication experience (facility, professional, ancillary).
• Excellent written and verbal communication; strong negotiation and prioritization skills.
• Demonstrated analytical and problem-solving abilities with a track record of process improvements.

Responsibilities

• Lead and develop remote claims teams, driving high performance and engagement.
• Manage unionized employees and ensure compliance with collective bargaining agreements.
• Oversee daily claims operations, workload distribution, productivity, and quality performance.
• Provide guidance to claims, vendors, partners, providers, and customers.
• Analyze performance trends and implement process improvements to boost efficiency and service quality.
• Manage escalated issues, complex claims, and high-value adjustments.
• Ensure accuracy of claims processing systems, workflows, and logic improvements.
• Coach and mentor staff to meet productivity and quality targets.
• Conduct audits, payroll reviews, and performance evaluations as needed.
• Develop training programs and onboarding for new hires and vendors.

Skills

Leadership

Communication

Analytical thinking

Time management

Interpersonal skills

Relationship building

Bilingual (preferred)

Education

Bachelor's degree preferred

Tools

Microsoft Word

Microsoft Excel

Job description

Magnacare LLC is seeking a Claims Manager to lead remote claims teams and drive performance and quality. The role requires strong leadership, strategic oversight, and collaboration with cross-functional partners to optimize workflows.

The position involves occasional travel to Las Vegas, NV for business needs and may require navigating unionized environments while maintaining service excellence for clients and members.