Manager, Claims Processing

CenterWell Senior Primary Care

Manager, Claims Processing overseeing claims adjustments and adjudications for home health, DME, and SNF claims. Leading teams to ensure compliance and efficiency in claims operations.

Posted 5/29/2026full-timeRemote • Florida • 🇺🇸 United StatesMid-LevelSenior💰 $78,400 - $107,800 per yearWebsite

About the role

Key responsibilities & impact

Oversee the review, adjudication, and resolution of home health, DME, home infusion and SNF claims, including Medicare, Medicaid, and commercial payer claims, ensuring compliance with payer guidelines, CMS regulations, and organizational policies.
Determine whether claims are paid, denied, returned, or adjusted based on clinical documentation, coding accuracy, authorization status, and payer requirements.
Manage escalated, complex, or high-risk claims issues, including denials, underpayments, and payer disputes.
Manage and develop claims processing professionals and/or claims supervisors; set performance expectations, provide coaching, and conduct performance reviews.
Identify, lead, and implement change initiatives to improve claims processing efficiency, denial rates, turnaround times, and cash flow.
Collaborate with Coding, Clinical Operations, Intake, Authorization, Finance, and Compliance teams to ensure accurate documentation and clean claim submission.

Requirements

What you’ll need

Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field, or equivalent combination of education and experience.
5+ years of progressive experience in claims processing, billing, or revenue cycle management within home health, DME, home infusion, SNF or related healthcare settings.
2 or more years of people management experience
Comprehensive knowledge of all Microsoft Office applications, including Word, Project and Visio
Strong working knowledge of Medicare, Medicaid, and commercial insurance reimbursement, EDI claims, and healthcare billing systems

Benefits

Comp & perks

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
short-term and long-term disability
life insurance and many other opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims processingbillingrevenue cycle managementcoding accuracyauthorization statusdenial managementpayer disputeshealthcare billing systemsEDI claimscompliance

Soft Skills

leadershipcoachingperformance managementcollaborationchange managementproblem-solvingcommunicationorganizational skillsanalytical skillsdecision-making