Remote Claims Operations Manager

hcsc; United States; Remote; USD 50,000 - 93,000; Full time

Job summary

Luminare Health is seeking a seasoned claims supervisor to oversee processing workflows across our care networks. You will lead a small team, optimize claims operations, and ensure timely and accurate adjudication while maintaining compliance and quality standards.

The ideal candidate has 3–5 years in claim processing and prior supervisory experience, with strong communication and leadership skills. Remote work is available nationwide (excludes CA, NY, AK, HI) and benefits are provided.

Qualifications

• High School Diploma or GED equivalent.
• 3-5 years claim processing experience.
• Previous supervisory or management experience.
• Self-directed individual who works well with minimal supervision.
• Excellent verbal and written communication skills.
• Strong leadership, organizational and interpersonal skills.
• Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff.
• Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form.
• Ability to effectively deal with problems in varying situations and reach resolution.
• Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs).
• Flexible; open to continued process improvement.
• Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word.

Skills

Supervisory experience

Communication skills

Leadership

Self-directed

MS Excel/Word

Problem solving

SPD interpretation

Education

Bachelor's degree

Tools

MS Excel/Word

Job description

Luminare Health is seeking a seasoned claims supervisor to oversee processing workflows across our care networks. You will lead a small team, optimize claims operations, and ensure timely and accurate adjudication while maintaining compliance and quality standards.

The ideal candidate has 3–5 years in claim processing and prior supervisory experience, with strong communication and leadership skills. Remote work is available nationwide (excludes CA, NY, AK, HI) and benefits are provided.