Remote Senior Claims Processing Manager

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

Job summary

Allied Benefit Systems, LLC in Chicago seeks an experienced Manager of Claims Processing to lead teams that ensure timely, accurate claims adjudication in alignment with SLAs, Plan Documents, and regulatory standards. You will manage inventories, drive data-driven improvements, and coordinate with internal partners to enhance member experience.

The role requires at least 5 years in medical claims analysis (including dental and vision), supervisory experience, and strong knowledge of CPT/HCPCS/

Qualifications

• Minimum 5 years of medical claims analysis and adjudication experience (including dental and vision).
• Minimum years of supervisor experience with demonstrated leadership competencies.
• Demonstrated understanding of Claims Management systems and platforms.
• Strong analytical and technical claims expertise across CPT, HCPCS, ICD-10, COB, and medical terminology.
• 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 for all books of business to ensure claims are handled timely and accurately.
• Lead initiatives to reduce inventory levels through data driven analysis, forecasting improvements, and innovative problem solving.
• Oversee networks, products, and client performance requirements with focus on service excellence and audit readiness.
• Manage elevated authority claim reviews to ensure timely handling within set dollar limits.
• Provide comprehensive support for new clients and products across all books of business.
• Collaborate with internal stakeholders to resolve escalated client issues and streamline workflows for better efficiency.
• Attend outside audits to ensure accurate reporting.
• Develop and implement strategies aligned with the company’s goals and objectives.
• Attend HIPAA training and other required education.
• Adhere to privacy and security laws including HIPAA and HITECH.
• Lead, coach, motivate and develop; conduct performance appraisals and growth opportunities.
• Clearly communicate expectations and provide training, resources, and information to succeed.
• Actively engage, coach, counsel and provide timely feedback.
• Other duties as assigned.

Skills

Medical claims analysis

Claims adjudication

Leadership

HIPAA knowledge

Education

Bachelor's degree

Tools

Claims systems

Job description

Allied Benefit Systems, LLC in Chicago seeks an experienced Manager of Claims Processing to lead teams that ensure timely, accurate claims adjudication in alignment with SLAs, Plan Documents, and regulatory standards. You will manage inventories, drive data-driven improvements, and coordinate with internal partners to enhance member experience.

The role requires at least 5 years in medical claims analysis (including dental and vision), supervisory experience, and strong knowledge of CPT/HCPCS/