[Hiring] Manager of Claims @Avesis

Role Description

As the Manager of Claims at Avesis, you will help create communities and systems of care that support everyone having access to quality healthcare and services while being treated with dignity. The Claims operations team at Avesis is responsible for timely and accurately processing all claims, ensuring provider payments are accurate and member benefits are maximized.

The Manager of Claims is responsible for:

• Direct oversight of Claims Supervisors, processing staff, and claims technology initiatives.
• Upholding and administering all claims processing functions.
• Leading the development and performance of the Claims Processing team.
• Ensuring high quality and timely outcomes.
• Work-flow oversight and assessment of error reduction initiatives.
• Consistent execution of claim payment procedures.
• Completion of special projects and overseeing supervisor team performance.
• Presenting relevant data, analysis, and solutions to the claims Executive Leadership Team.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• Minimum 5 years supervisory or management experience leading a production team.
• Minimum 3+ years’ experience leading or participating in the development of claim enhancements.
• Knowledge of Medicare, Medicaid, and/or Commercial insurance terminology.
• Advanced in Microsoft Office products.
• Ability to work flexible hours to accommodate business needs.
• Excellent listening and communication skills (verbal and written).

Requirements

• Ensure direct oversight of Claims Supervisors and claims support staff.
• Demonstrate knowledge of contracts and performance requirements.
• Oversight of timely and accurate processing of claims.
• Interview, select, and hire applicants for various Claims department positions.
• Manage employee performance and set goals.
• Monitor claims inventory and assist claims supervisors.
• Assist in monitoring, planning, and assigning employee job requirements.
• Ensure quality and productivity standards are monitored.
• Assist management and processors in resolving aged claims.
• Identify opportunities for improvement plans.
• Support audit activity when needed.
• Participate in annual review and maintenance of departmental workflow.
• Communicate timely with internal Avesis stakeholders.
• Perform other duties occasionally as assigned.

Benefits

• Meaningful and challenging work opportunities.
• Competitive compensation package.
• Excellent medical, dental, supplemental health, life, and vision coverage.
• Life and disability insurance.
• A great 401(k) with company match.
• Tuition assistance, paid parental leave, and backup family care.
• Dynamic, modern work environments that promote collaboration.
• Flexible time off, dress code, and work location policies.
• Employee Resource Groups that advocate for inclusion and diversity.
• Social responsibility initiatives within local communities.