Remote Senior Claims Configuration Lead

Ladders; United States; À distance; USD 111 000 - 150 000; Plein temps

Avantages offerts par ce poste

Health plan

Dental plan

Vision plan

Paid time off

Mobile stipend

Stock options

Bonus eligibility

Parental leave

401K

Résumé du poste

Ladders is seeking a Claims Configuration Senior Manager to join its team, focusing on critical claims configuration processes that influence payment accuracy, efficiency, and member/provider experience. This role acts as SME on complex claims logic across operations and tech stakeholders to improve automation and resolve issues. Location: Remote.

Compensation: $110,500 – $150,000 annually. The role measures performance, identifies root causes, and drives sustainable improvements in a highly

Qualifications

• 6+ years of experience in business operations or operational leadership.
• Comfort with ambiguity and deep understanding of complex claims system logic.
• Exceptional communication skills for both technical and non-technical audiences.
• Proven track record of driving change and measurable results in fast-paced environments.
• Strong analytical skills with experience in KPI development and large dataset analysis.
• Ability to thrive in a metrics-driven environment while managing multiple initiatives.

Responsabilités

• Own the auto-adjudication rate and evaluate flags for manual review.
• Serve as the expert on claims matching to provider contracts.
• Ensure accuracy of member EOBs and provider EOPs.
• Support remittance outputs and resolve processing issues.
• Identify errors and lead root cause analysis for sustainable fixes.
• Establish performance measurement frameworks for claims logic.
• Recommend improvements based on regulatory changes and emerging technology.

Connaissances

6+ years of experience in business ops

Ambiguity tolerance

Exceptional communication

Change leadership

Analytical skills with KPI

Multitasking in fast-paced env

Description du poste

Ladders is seeking a Claims Configuration Senior Manager to join its team, focusing on critical claims configuration processes that influence payment accuracy, efficiency, and member/provider experience. This role acts as SME on complex claims logic across operations and tech stakeholders to improve automation and resolve issues. Location: Remote.

Compensation: $110,500 – $150,000 annually. The role measures performance, identifies root causes, and drives sustainable improvements in a highly