Remote Claims Operations Leader

Alliance Health; Morrisville (NC); Hybrid; USD 70,000 - 89,000; Full time

Benefits offered by this job

Hybrid/Remote options

Good retirement plan

Paid time off

Job summary

Alliance Health is seeking a Claims Supervisor to oversee claims data entry, payments, credits, and adjustments, and to train a Claims Research Analyst team. The role emphasizes complex decision making and information management system analysis, with a strong focus on performance metrics and provider partnerships.

The position offers a primarily remote schedule with intermittent onsite training and team meetings, and includes a comprehensive fringe benefits package upon hire.

Qualifications

• Bachelor’s degree from an accredited college or university in Business Administration or related field.
• Three (3) years of experience in claims leadership experience with focus in leading projects and people.

Responsibilities

• Supervise Claims Operations and compile performance reports.
• Assess production, quality levels, and provider/member feedback.
• Ensure staff are resolving claims promptly and escalate when necessary.
• Maintain billing and reimbursement system and monitor reports to improve productivity.
• Lead staff development, coaching, and mentoring to advance team skills.
• Collaborate with Contracts, Credentialing, Enrollment, and Provider Network teams on submissions.

Education

Bachelor's degree in Business Administration or related field

Job description

Alliance Health is seeking a Claims Supervisor to oversee claims data entry, payments, credits, and adjustments, and to train a Claims Research Analyst team. The role emphasizes complex decision making and information management system analysis, with a strong focus on performance metrics and provider partnerships.

The position offers a primarily remote schedule with intermittent onsite training and team meetings, and includes a comprehensive fringe benefits package upon hire.