Claims Operations Manager

Job Summary

A company is looking for a Manager, Claims Operations to oversee claims production and reporting teams.

Key Responsibilities

• Manage day-to-day operations of the Claims Operations team and ensure KPIs are met
• Monitor claims processing performance, identify issues, and implement action plans for improvement
• Conduct performance reviews, mentor staff, and maintain desktop procedures for claims processing

Required Qualifications

• 3 - 5 years of management experience in claims operations
• Advanced knowledge of claims processing and data analysis
• Proficient in Microsoft applications, including Excel and Access
• Experience with HMO Medical insurance claims and EDI transactions
• Understanding of claims compliance requirements and project management experience