Manager of Claims Resolution

Job Summary

A company is looking for a Manager, Complex Issue Resolution to join their Claims Production team.

Key Responsibilities

• Serve as the subject matter expert for claims operations, including regulatory requirements and workflows
• Lead a team in conducting root-cause analysis of complex claims issues and implement corrective plans
• Manage claims professionals, ensuring quality and compliance while providing coaching and performance management

Required Qualifications

• Bachelor's degree or 4+ years of relevant experience
• 4+ years of experience in leading and developing teams in a healthcare claims organization
• 4+ years of experience in data analysis to resolve complex claims issues
• 2+ years of experience in implementing process and workflow improvements