Call Center Claims Operations Manager

Leading Edge Connections • Amherst, NY

19h • Onsite

About The Position

LEC is seeking an experienced and motivated CSC Operations Manager to oversee our team of remote Healthcare Administrative Claims Agents. This role is responsible for ensuring day-to-day operations run efficiently while maintaining high standards for productivity, quality, accuracy, client service, and compliance.
The ideal candidate is a strong people leader who understands call center operations, healthcare administration, insurance claims, or revenue cycle processes and can effectively coach a team that communicates directly with insurance carriers and payer representatives.
The Operations Manager will manage, coach, and support a team of remote Claims Specialists responsible for outbound insurance calls, claims follow-up, eligibility verification, provider credentialing inquiries, prior authorization status checks, and detailed documentation.
This position will serve as a key connection between LEC leadership, remote agents, and clients. The Operations Manager will monitor team performance, identify opportunities for improvement, resolve operational issues, and ensure agents consistently follow established procedures and client requirements.

Requirements

• 2+ years of management, supervisory, or team-lead experience, preferably in a call center, healthcare, insurance, claims, or administrative environment.
• Healthcare, insurance claims, medical billing, or revenue cycle experience strongly preferred.
• Experience managing remote or distributed teams is a plus.
• Strong understanding of call center performance metrics and quality standards.
• Excellent verbal and written communication skills.
• Strong leadership, coaching, problem-solving, and conflict-resolution abilities.
• Highly organized with strong attention to detail.
• Comfortable working with multiple computer systems and platforms.
• Ability to analyze performance data and identify trends or opportunities for improvement.
• Ability to enforce policies and procedures while maintaining positive employee relationships.
• Strong time-management and multitasking skills.
• High School Diploma or equivalent required; college degree or relevant professional experience preferred.

Nice To Haves

• The successful candidate will be a hands-on leader who is comfortable balancing people management, performance management, and day-to-day operations.
• Leads by example.
• Holds team members accountable while providing meaningful support.
• Is comfortable having difficult conversations when necessary.
• Uses data and performance metrics to make decisions.
• Can identify problems and develop practical solutions.
• Communicates clearly and professionally.
• Understands the importance of accuracy and documentation in healthcare administration.
• Can effectively manage employees working remotely while maintaining engagement and accountability.

Responsibilities

• Directly manage and support a team of remote Healthcare Administrative Claims Agents.
• Provide daily leadership, direction, coaching, and accountability to team members.
• Monitor attendance, schedules, workload, productivity, and overall team performance.
• Conduct regular one-on-one meetings, coaching sessions, and performance reviews.
• Identify employee strengths and development opportunities.
• Address performance concerns professionally and consistently.
• Promote a positive, accountable, and team-oriented work environment.
• Oversee daily claims follow-up and healthcare administrative operations.
• Ensure agents follow established processes, scripts, workflows, and client-specific requirements.
• Monitor work queues and ensure tasks are completed accurately and within required timeframes.
• Identify workflow bottlenecks and implement process improvements.
• Ensure appropriate coverage and distribution of work across the team.
• Escalate operational issues and client concerns when appropriate.
• Help develop and maintain standard operating procedures and training materials.
• Monitor key performance indicators, including productivity, quality, accuracy, call activity, documentation, and task completion.
• Conduct quality reviews of agent work and documentation.
• Provide actionable feedback and coaching based on performance results.
• Ensure agents accurately document insurance calls, claim statuses, payer responses, and follow-up requirements.
• Track team performance against client expectations and internal goals.
• Develop corrective action and improvement plans when necessary.
• Assist with onboarding and training new Claims Specialists.
• Reinforce proper call handling, documentation, and payer inquiry procedures.
• Identify recurring training needs and coordinate refresher training.
• Help agents improve communication, productivity, accuracy, and system proficiency.
• Maintain consistency in processes across the team.
• Serve as an escalation point for agent questions and operational issues.
• Communicate effectively with LEC leadership regarding team performance and operational needs.
• Assist with client communications and service-related escalations.
• Ensure client expectations and process changes are communicated clearly to the team.
• Provide regular reporting and updates regarding team performance and operational trends.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED