TPA Operations Manager - Claims, Member Services & Projects

Paycom; Austin (TX); On-site; USD 80,000 - 100,000; Full time

Job summary

Paycom is seeking a TPA Services Manager to oversee daily supervision of core TPA operations in Austin, including claims processing, member services and special projects. You will work with the Director of TPA Services to meet service standards and support staff performance.

The ideal candidate has 3–5 years in TPA/claims, supervisory experience, and proficiency with MS Office and claims systems; familiarity with ERISA and HIPAA is a plus.

Qualifications

• Bachelor’s degree or equivalent work experience in Business/Related field.
• 3–5 years of experience in TPA operations, health insurance claims, or managed care administration.
• 1–2 years of supervisory or team lead experience.
• Working knowledge of claims processing, member services operations, and stop loss concepts.
• Familiarity with ERISA, HIPAA, and self-funded health plan administration basics.

Responsibilities

• Supervise day-to-day claims intake, adjudication, and payment workflows for accuracy and timely turnaround.
• Monitor claims inventory and production queues; identify and resolve backlogs or errors.
• Conduct routine audits and quality checks; report error trends and support corrective actions.
• Oversee call center operations including staff scheduling and performance tracking.
• Coach staff to maintain call quality and member service; handle escalated inquiries.
• Manage operational projects such as process improvements, system upgrades, or client onboarding.
• Prepare operational reports and dashboards for leadership review.

Skills

Supervisory experience

TPA operations experience

Claims processing knowledge

MS Office proficiency

Multitasking under deadlines

Education

Bachelor’s degree in Business or related field

Healthcare Administration/Insurance background

Tools

DialPad

ElDorado

Job description

Paycom is seeking a TPA Services Manager to oversee daily supervision of core TPA operations in Austin, including claims processing, member services and special projects. You will work with the Director of TPA Services to meet service standards and support staff performance.

The ideal candidate has 3–5 years in TPA/claims, supervisory experience, and proficiency with MS Office and claims systems; familiarity with ERISA and HIPAA is a plus.