Claims Operations Manager

Job Summary

A company is looking for a Manager, Claims Operations.

Key Responsibilities

• Oversee the day-to-day management of the Claims Operations team and ensure KPIs are met
• Monitor claims processing operations, identify issues, and implement improvements to workflows
• Utilize data analytics to track performance metrics and conduct staff performance reviews

Required Qualifications

• 3-5 years of management experience in claims operations
• Advanced knowledge of claims processing and data analysis
• Proficiency in Microsoft applications, especially Excel
• Experience with HMO medical insurance claims and EDI transactions
• Understanding of claims processing compliance requirements