Manager Claims - LH
About The Position
At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success. We're committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable. Job Summary The Claim Manager is responsible for the day-to-day supervision and management of a team, or multiple teams, of Luminare Health Claim Analysts and/or outsourced vendor staff enabling the department to meet its client and corporate commitments. Responsibilities include, but are not limited to, successful achievement of team quality, production and service expectations, staff development, successful implementation of new clients into the Unit, and retention of existing clients. The Manager is responsible for answering complex or difficult claim or customer service questions, advising team members regarding claim processing or customer service procedures, and providing support to ensure all department goals are met. The Manager is expected to have greater visibility and accountability than a Claim Supervisor. This may involve responsibility for multiple Claim Units, each with its own Supervisor, a Claim Unit with more complex or visible clients, and/or management of an outsourced vendor relationship.
Requirements
- High School Diploma or GED equivalent
- 3-5 years claim processing experience
- Previous supervisory or management experience
- Self-directed individual who works well with minimal supervision
- Excellent verbal and written communication skills
- Strong leadership, organizational and interpersonal skills
- Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
- Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
- Ability to effectively deal with problems in varying situations and reach resolution
- Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
- Flexible; open to continued process improvement
- Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word
Nice To Haves
- Bachelor’s degree
- Self-Funded Insurance/Benefits and/or TPA experience
Responsibilities
- Day-to-day supervision and management of a team, or multiple teams, of Luminare Health Claim Analysts and/or outsourced vendor staff.
- Ensure the department meets its client and corporate commitments.
- Achieve team quality, production, and service expectations.
- Staff development.
- Successful implementation of new clients into the Unit.
- Retention of existing clients.
- Answering complex or difficult claim or customer service questions.
- Advising team members regarding claim processing or customer service procedures.
- Providing support to ensure all department goals are met.
- Responsibility for multiple Claim Units, each with its own Supervisor, a Claim Unit with more complex or visible clients, and/or management of an outsourced vendor relationship.
Benefits
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
- Other incentives
- Annual incentive bonus plan
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
High school or GED
