Claims Manager

Job Summary

To optimize claims performance for diagnostic laboratory services, the full-time remote Claims Manager will oversee the claims process, manage the Claims team, and collaborate with billing vendors and internal stakeholders to ensure compliance with payer requirements and improve reimbursement outcomes.

Key responsibilities

• Lead the claims process from submission to resolution, ensuring timely and accurate reimbursement
• Oversee the review and resolution of denied, pending, and aging claims, implementing corrective actions as needed
• Monitor claims inventory and accounts receivable performance to meet service level expectations

Required qualifications

• Bachelor's degree in healthcare administration, business, finance, or equivalent experience in a related field
• 5-7 years of experience in laboratory billing, insurance claims, or revenue cycle management, with a focus on claims operations
• Strong understanding of insurance claim processes, healthcare regulations, and compliance requirements
• Advanced knowledge of payer requirements and denial management methodologies
• Experience using Microsoft Office applications and familiarity with AI tools for operational improvements