Senior Claims Operations Leader

Avesis Incorporated; Texas; Hybrid; USD 74,000 - 145,000; Full time

Benefits offered by this job

Competitive compensation

Excellent medical, dental, vision

401(k) with company match

Tuition assistance

Paid parental leave

Flexible time off

Job summary

Avesis Incorporated in the United States is seeking a Manager of Claims to oversee Claims Supervisors and processing staff, driving timely, accurate claim handling and operational excellence across our vision and dental benefits platform.

The role emphasizes workflow leadership, performance management, and collaboration with executives to improve accuracy, turnaround times, and customer satisfaction while ensuring compliance with contract and regulatory requirements.

Qualifications

• Bachelor's degree or equivalent required; supervisory/management experience preferred.
• Minimum 5 years in supervisory or management roles leading a production/claims team.
• 3+ years in development of claim enhancements, auto-adjudication triggers, or RPA in claims systems.
• Knowledge of Medicare, Medicaid, or Commercial insurance terminology and claim payment processes.
• Proficiency in MS Office and data analysis; ability to work across time zones.

Responsibilities

• Oversee Claims Supervisors and staff; manage workflows and performance reviews.
• Ensure timely, accurate claims processing per contracts and regulatory requirements.
• Hire and develop staff; monitor productivity and quality metrics.
• Present data and improvement plans to Claims leadership; drive process improvements.
• Assist in audit activities and update SOPs and policies.

Skills

Leadership

Claims processing

Data analysis

Workflow management

Communication

Education

Bachelor's degree or equivalent

Master’s degree preferred

Tools

Microsoft Office

Excel

Claims software

Job description

Avesis Incorporated in the United States is seeking a Manager of Claims to oversee Claims Supervisors and processing staff, driving timely, accurate claim handling and operational excellence across our vision and dental benefits platform.

The role emphasizes workflow leadership, performance management, and collaboration with executives to improve accuracy, turnaround times, and customer satisfaction while ensuring compliance with contract and regulatory requirements.