Sr. Manager of Claims Operations

ZipRecruiter; Denver (CO); Remote; USD 70,000 - 85,000; Full time

Job summary

A leading company is seeking a Senior Manager of Claims Operations to oversee billing and claims management. This remote role requires strong leadership and communication skills, focusing on process efficiency and team performance. The ideal candidate will have extensive experience in healthcare billing and a commitment to compliance and quality.

Benefits

401k with match

Unlimited PTO

Medical/Dental/Vision insurance

Employee Assistance Program

Qualifications

• 4+ years in healthcare billing and claims.
• 2+ years in team leadership.

Responsibilities

• Oversee the entire billing cycle and ensure claims are processed timely.
• Recruit team members with relevant experience in Mental Health/Substance Abuse billing.
• Collaborate with departments to reconcile reports.

Skills

Communication

Judgment

Education

High school diploma/GED

Bachelor's degree or equivalent experience

Coding certification

Job description

Job Description

Position: Sr. Manager of Claims Operations

Job Type: Full Time

Location: Remote - Residence in Colorado

Compensation: $70,000-85,000 Annual Salary + Incentives

About The Role

We are seeking a highly skilled Senior Manager of Claims Operations to oversee daily billing and claims management operations. This role is ideal for someone who thrives in a data-driven, hands-on managerial position and is committed to driving efficiency and accuracy in billing and collections processes. The successful candidate will have a strong process orientation and a drive to succeed on behalf of the organization and patients.

Billing & Collections

• Oversee the entire billing cycle, ensuring claims are processed timely by following established protocols, with attention to detail and effective prioritization and escalation.
• Build relationships with insurance payors to meet needs and optimize timely, friction-free payments.
• Process insurance claims for private and employer insurance reimbursement.
• Follow up on payor denials, consulting with clients and/or families as needed.
• Utilize data to identify and address root causes of payor denials.
• Manage and intervene as needed for complex claim denials.
• Manage team performance against specific metrics.
• Post payments promptly.

Quality & Compliance

• Complete necessary documentation and timely entries, maintaining compliance with documentation standards.
• Assist in preparing documents for annual billing audits.
• Ensure financial records meet audit and compliance standards, adhering to regulatory and payor requirements.

Team Leadership & Training

• Recruit team members with relevant experience in Mental Health/Substance Abuse billing & coding.
• Record attendance in billing software for claims submission.
• Onboard new staff with thorough training on procedures and expectations.
• Provide ongoing support and training updates to the team.

Collaboration & Communication

• Collaborate with departments like Billing Operations, Benefits Verification, and Revenue Operations to reconcile reports.
• Provide regular billing reports and summaries to stakeholders.
• Assist in reconciling billing data with financial records.
• Participate in committees, meetings, and community activities.
• Contribute to continuous process improvements and facility-wide initiatives.

Qualifications

Education Requirements

• High school diploma/GED required.
• Bachelor's degree or equivalent experience preferred.
• Coding certification or associate's degree in related fields advantageous.

Experience Requirements

• 4+ years in healthcare billing and claims.
• 2+ years in team leadership.
• Experience with complex claims adjudication.
• Valid driver's license required.
• Strong communication and judgment skills.

Other Requirements

• Successful background check including criminal and motor vehicle records.

The Perks

We offer a comprehensive benefits package including competitive salary, bonus incentives, 401k with match, unlimited PTO, medical/dental/vision insurance, Employee Assistance Program, and a supportive community environment.

Interview Process

1. Application review within one business day.
2. 30-minute discovery call with a recruiter.
3. 1-2 interviews with Revenue Cycle Management leadership.
4. Job offer contingent on background check.

Expected timeline: 2-3 weeks.

Our Commitment to Equity

We are dedicated to fostering a diverse, inclusive culture that values all backgrounds and promotes equity. We are an equal opportunity employer and do not discriminate based on any protected status.