Manager, Claim Processing

Job Description: Manages day-to-day activities of team by providing strategic leadership and overseeing the operations of the claims processing team(s)Directs work flow to ensure the efficient and accurate processing of medical claims by establishing and monitoring productivity and quality metricsAddresses any complex or escalated claims issues to provide guidance to claim processors in handling challenging casesDesigns quality control processes to ensure the accuracy and consistency of claim processingAssists with the development of the claim processing budget by monitoring expenses and identifying cost-saving opportunitiesAnalyzes claim processing data and generates reports to track and evaluate key performance metricsCollaborates with other departments to ensure effective communication and coordination in the claim processing workflowEnsures compliance with industry regulations and company policiesRequirements: 5–7 years of experience in healthcare claims and/or operations5–7 years of demonstrated leadership experience, including team oversight and performance managementstrong execution and delivery capabilities, including planning, implementation, and ongoing supportstrong problem‐solving and sound decision‐making capabilities in complex environmentsproven ability to collaborate effectively across teams and build strong partnerships with diverse stakeholdersexhibits a growth mindset, including adaptability, continuous learning, and the ability to develop self and othersstrong written and verbal communication skillsCertified Billing and Coding Specialist (CBCS) preferredCandidates located on the East Coast preferredBenefits: medical, dental, and vision coveragepaid time offretirement savings optionswellness programscomprehensive benefits package based on eligibility