Remote Claims Processing Leader

Allied Benefit Systems, LLC; Chicago (IL); Remote; USD 70,000 - 85,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Paid Time Off

Flexible remote work

Job summary

Allied Benefit Systems, LLC is seeking a Manager of Claims Processing to lead cross-functional teams in processing medical claims in line with SLAs, plan documents, and regulatory standards. The role oversees inventories, improves workflows, and supports new clients and products across books of business.

The ideal candidate has 5+ years in medical claims analysis with supervisory experience, strong CPT/HCPCS/ICD-10 knowledge, and excellent communication and problem-solving skills.

Qualifications

• Minimum 5 years of medical claims analysis and adjudication experience (including dental and vision).
• Minimum 5 years in a supervisor role with demonstrated leadership competencies.
• Strong knowledge of CPT, HCPCS, ICD-10 and COB.
• Excellent written and verbal communication skills.
• Exceptional time management and ability to prioritize work.
• Strong problem solving and conflict resolution skills and ability to handle sensitive client escalations.

Responsibilities

• Monitor inventory, productivity, and quality reports to ensure timely, accurate claims processing.
• Lead initiatives to reduce inventory through data-driven analysis and forecasting improvements.
• Oversee networks, products, and client performance with focus on service excellence and audit requirements.
• Manage elevated authority claim reviews to ensure accurate, timely releases within set limits.
• Collaborate with internal stakeholders to resolve escalated client/broker issues and streamline workflows.

Skills

Leadership

Analytical thinking

CPT/HCPCS/ ICD-10

Communication

Time management

Problem solving

Escalation handling

Education

Bachelor's degree or equivalent

Job description

Allied Benefit Systems, LLC is seeking a Manager of Claims Processing to lead cross-functional teams in processing medical claims in line with SLAs, plan documents, and regulatory standards. The role oversees inventories, improves workflows, and supports new clients and products across books of business.

The ideal candidate has 5+ years in medical claims analysis with supervisory experience, strong CPT/HCPCS/ICD-10 knowledge, and excellent communication and problem-solving skills.