Manager, Claims – Tribal Health
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Job Description
Claim Manager overseeing claim analysts and vendor staff for Luminare Health. Focused on client retention, staff development, and ensuring operational goals are met.
Responsibilities:
- Responsible for the day-to-day supervision and management of a team of Claim Analysts and/or outsourced vendor staff
- Successful achievement of team quality, production and service expectations
- Staff development and successful implementation of new clients into the Unit
- Retention of existing clients
- Answer complex or difficult claim or customer service questions
- Advise team members regarding claim processing or customer service procedures
- Provide support to ensure all department goals are met
- May involve responsibility for multiple Claim Units or management of an outsourced vendor relationship
Requirements:
- High School Diploma or GED equivalent
- 3-5 years claim processing experience
- Previous supervisory or management experience
- Self-directed individual who works well with minimal supervision
- Excellent verbal and written communication skills
- Strong leadership, organizational and interpersonal skills
- Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
- Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
- Ability to effectively deal with problems in varying situations and reach resolution
- Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
- Flexible; open to continued process improvement
- Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word
Benefits:
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
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