Claims Manager

Delta Health Systems

Director of Operations overseeing daily operations at Delta Health Systems in Stockton and Fresno. Leading teams and driving operational excellence for client satisfaction.

Posted 7/3/2026full-timeStockton • California • 🇺🇸 United StatesJuniorMid-Level💰 $73,000 - $78,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong leadership and management skills in overseeing staff performance, training, and development while ensuring compliance with health insurance claims regulations. Proficient in managing operations within budget constraints and fostering effective interdepartmental and client relationships.

Highest-signal resume keywords

Management ExperienceClaims ExperienceLeadership AbilitiesCommunication SkillsAutomated Claims Systems

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims Policies UnderstandingSpreadsheet ProficiencyWord Processing ProficiencyPerformance Review ConductingCorrective Action Implementation

Soft Skills

Interpersonal SkillsMentoringConflict ResolutionRelationship BuildingTeam Collaboration

Industry Keywords

Health Insurance ClaimsSelf-Funded Payer ClaimsFederal RegulationsState RegulationsCoding Methodologies

About the role

Key responsibilities & impact

Supervise assigned staff in a responsible manner including training, planning, directing work, appraising performance, rewarding, and addresses complaints.
Mentors, educates, and provides corrective action, performance improvement plans, and disciplines staff when necessary.
Participants in the interview process for the hiring of new staff when necessary.
Conducts monthly 1:1, quarterly, and annual performance reviews with staff to discuss productivity, issues, concerns, quality, and expectations.
Responds to staff, internal and external customer inquiries, and provides resolution to issues accordingly.
Evaluates department performance and takes corrective action, when necessary.
Ensures overall inventory and assigned queues and processes are handled within department guidelines.
Reviews department reports for accuracy, thoroughness, and timeliness and adjusts measurements when necessary.
Interprets plan provisions and make recommendations for system administrative improvements to meet customer expectations.
Develop relationships with other departments to ensure interdepartmental communication is effective.
Develops and maintains effective relationships with customers and their affiliated partners.
Manages within established budget of unit.
Collaborates with information services on system enhancements, providing documentation and justification for improvements to system for proper claims flow.
Assists Client Services with client requests to meet customer expectations, requests, and deadlines.
Participate in new business implementations.
Enforces, adheres to, and follows department policies and procedures and Collective Bargaining Agreements.
Participates in and contributes to department meetings and continual training.
Represents company at existing and prospective customer meetings.
Upholds and exemplifies company values.
Must occasionally travel to client locations.

Requirements

What you’ll need

Two to four years of management and claims experience
Must be computer literate w/proficiency in spreadsheet and word processing applications
Excellent written and verbal communication skills
Must have excellent leadership abilities and interpersonal skills; ability to establish confidence, rapport and foster cooperative relationships with clients, providers, and co-workers.
Must understand self-funded payer claims policies as well as Federal, State and other regulations pertaining to health insurance claims payment including TPL, COB, and coding and reimbursement methodologies.
Experience with automated claims systems; and ability to maintain sound production operations also required

Benefits

Comp & perks

Health insurance
Professional development opportunities
Flexible work arrangements