Senior Claims Manager
Job Summary
Overseeing a claims processing organization, the full-time Senior Claims Manager will ensure timely claims processing in compliance with government regulations, develop adjudication policies, and lead operational initiatives while working remotely.
Key responsibilities
- Manage overall department operations, ensuring compliance with policies and service level agreements
- Analyze workflow to meet production and staffing needs, implementing process improvements
- Research and respond to escalated service issues, providing corrective actions and approvals for complex claims
Required qualifications
- Bachelor's Degree with 4-6 years of related experience, or High School Diploma/GED with 6-8 years of related experience
- Experience in claims processing and adjudication policies
- Proven ability to manage cross-functional teams and projects
- Strong analytical skills for assessing cost-effectiveness and identifying trends
- Familiarity with government regulations and industry standards in claims management
Complete Job Description
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