Claims Manager- Hybrid (Indianapolis, Indiana)

Gainwell Technologies LLC•Indianapolis, IN

8d•$86,000 - $123,900•Hybrid

About The Position

As a Claims Manager at Gainwell Technologies, you will lead claims operations supporting Indiana Medicaid programs while ensuring service excellence, regulatory compliance, and operational efficiency. This role is responsible for overseeing claims processing functions, driving performance improvements, supporting client relationships, and leading teams responsible for delivering high-quality claims outcomes. Your role in our mission is to lead daily claims operations to ensure service levels, quality standards, and client expectations are consistently achieved. You will manage teams responsible for claims adjudication, adjustments, escalations, inventory management, and issue resolution. You will also monitor operational metrics and identify opportunities to improve productivity, accuracy, compliance, and customer satisfaction. Additionally, you will partner with clients, business stakeholders, and cross-functional teams to support operational initiatives and claims enhancements, and ensure compliance with federal and state regulations, including Medicaid and HIPAA requirements. You will coach, mentor, and develop team members while fostering a culture of accountability and continuous improvement.

Requirements

5 + years of healthcare claims processing experience, including adjudication, adjustments, issue resolution, and claims operations.
3+ years of leadership experience managing claims teams, supervisors, or operational staff.
Strong knowledge of Medicaid claims processing, payment methodologies, and healthcare claims regulations.
Experience working with claims systems, operational reporting, dashboards, and performance metrics.
Ability to lead cross-functional initiatives, solve complex operational challenges, and drive process improvements.

Nice To Haves

Indiana Medicaid and Managed Care Organization (MCO) experience strongly preferred.

Responsibilities

Lead daily claims operations to ensure service levels, quality standards, and client expectations are consistently achieved.
Manage teams responsible for claims adjudication, adjustments, escalations, inventory management, and issue resolution.
Monitor operational metrics and identify opportunities to improve productivity, accuracy, compliance, and customer satisfaction.
Partner with clients, business stakeholders, and cross-functional teams to support operational initiatives and claims enhancements.
Ensure compliance with federal and state regulations, including Medicaid and HIPAA requirements.
Coach, mentor, and develop team members while fostering a culture of accountability and continuous improvement.