Remote Claims Operations Leader

Avesis; Phoenix (AZ); Remote; USD 74,000 - 145,000; Full time

Benefits offered by this job

Competitive pay

Excellent health coverage

401(k) with company match

Tuition assistance

Flexible time off

Diversity & inclusion programs

Job summary

Avesis is hiring a Manager of Claims to oversee Claims Supervisors and processing staff, ensuring high-quality, timely claim payments across our national network. This remote role supports audits, workflow improvements, and performance management within defined SLAs.

The position requires extensive claims knowledge, leadership, and collaboration with executives to optimize processing and member outcomes. Compensation reflects market bands across Zone A–C in the United States.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 5+ years supervisory or management experience leading a production team.
• 3+ years' experience leading claim enhancements, including 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, Adobe, and other Windows-based tools.

Responsibilities

• Oversee Claims Supervisors and staff; manage workflows and performance reviews.
• Understand contracts and performance requirements and ensure compliant claims processing.
• Oversee timely and accurate processing of claims within contractual/regulatory time frames.
• Interview, select and hire applicants for Claims department roles.
• Manage performance, set goals, oversee workloads, monitor productivity/quality.
• Monitor claims inventory and assist supervisors to address concerns.
• Develop goals and objectives for supervised team members.
• Ensure quality and productivity standards and provide frontline feedback.
• Assist in resolving aged claims and claims adjustment projects.
• Present and communicate claims processing updates to leadership.

Skills

Supervisory experience

Claims processing

CPT/HCPC knowledge

Analytical skills

Communication skills

Leadership

Education

Bachelor's degree

Tools

Microsoft Office

Excel

Word

Adobe

Job description

Avesis is hiring a Manager of Claims to oversee Claims Supervisors and processing staff, ensuring high-quality, timely claim payments across our national network. This remote role supports audits, workflow improvements, and performance management within defined SLAs.

The position requires extensive claims knowledge, leadership, and collaboration with executives to optimize processing and member outcomes. Compensation reflects market bands across Zone A–C in the United States.