Senior Claims Operations Manager

Blue Cross and Blue Shield of North Carolina; North Carolina; On-site; USD 108,000 - 173,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401(k) with company match

Parental leave and adoption support

Tuition reimbursement

Job summary

Blue Cross NC is seeking a Manager, Claims to implement an end-to-end service model across provider segments and drive performance against business targets. You will manage claims submission, refunds, recovery, and accounting, collaborating with leadership to meet contractual obligations and ensure accurate financial reporting.

The role requires leadership of a team, experience with claims systems, and the ability to deliver improvements across processing and reporting functions within a

Qualifications

• Bachelor's degree or advanced degree (where required).
• 8+ years of experience in related field.
• In lieu of degree, 10+ years of experience in related field.

Responsibilities

• Streamline shared processing to reduce management by exception.
• Set operational process to address market trends, BCBSNC capabilities and customer demand.
• Oversee accounting and financial reporting to ensure compliance with accepted principles.

Skills

Claims management

Financial analysis

Leadership

Process improvement

Stakeholder collaboration

Education

Bachelor's degree

Advanced degree

10+ years experience in lieu of degree

Tools

Facets

Job description

Blue Cross NC is seeking a Manager, Claims to implement an end-to-end service model across provider segments and drive performance against business targets. You will manage claims submission, refunds, recovery, and accounting, collaborating with leadership to meet contractual obligations and ensure accurate financial reporting.

The role requires leadership of a team, experience with claims systems, and the ability to deliver improvements across processing and reporting functions within a