Claims Manager
HJ Staffing
contract
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Oversee claims processing and ensure CMS/state compliance.
- Lead, train, and mentor claims team.
- Conduct audits and implement process improvements.
- Collaborate with provider relations, finance, and UM teams.
- Track KPIs and report on operational performance.
Requirements
- Bachelor’s in Business or Healthcare Administration.
- 5+ years managed care claims management experience.
- Expertise in Medicare Advantage and ISNP operations.
- Experience with Plexis or similar systems preferred.
- Strong analytical, leadership, and Excel skills.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims processingMedicare Advantage operationsISNP operationsauditingprocess improvementsKPI trackingExcel
Soft skills
leadershiptrainingmentoringanalytical skillscollaboration
Certifications
Bachelor’s in Business AdministrationBachelor’s in Healthcare Administration