Medical Claims Manager

Amwins • Scottsdale, AZ

4d • Hybrid

About The Position

Amwins Self-Funded is seeking a Claims Manager to lead and support a claims team, oversee day-to-day operations, strengthen processes, and help deliver high-quality service to clients and partners. The role is primarily in-office, with the opportunity to work from home up to two days per week after completing training.

The manager oversees team performance and development, works with Claims Quality and Claims Training partners, manages department case records and workload assignments, and provides subject-matter support for complex or high-priority claims. The role also supports Stop Loss claim filing, reimbursement reporting, and carrier notifications when applicable. The manager collaborates with the Director of Claims and internal and external partners to improve processes and maintain responsive, consistent service.

The position offers a competitive benefits package, paid time off and holidays, learning and career-growth opportunities, and an annual performance-based bonus program.

Requirements

• At least 2 years of management experience, with an interest in leading, coaching, and developing others.
• Proficiency with Microsoft Office programs, including Excel, Outlook, SharePoint, and Teams.
• Ability to manage time, prioritize workload, and meet deadlines.
• Strong teamwork skills and ability to work cooperatively and respectfully with staff members and business partners.
• Strong organizational and multitasking skills.
• Ability to communicate clearly, professionally, and thoughtfully with internal and external partners.
• Strong attention to detail, follow-through, and sense of urgency.
• Supportive, solutions-oriented leadership approach and commitment to helping the team and business succeed.

Nice To Haves

• Bachelor's degree or 3–5+ years of experience working in Group Benefits.
• 3–5 years of claims or production-environment experience.

Responsibilities

• Lead day-to-day operations and support the success of assigned Claims team members, including staffing recommendations, promotions, performance evaluations, and disciplinary actions as applicable.
• Support team member performance through regular feedback, accountability conversations, training, and technical coaching; partner with the assigned Claims Lead on coaching and process guidance.
• Partner with the Claims Quality team, review QA reports on a defined cadence, monitor team-level quality trends, and request additional audit coverage when appropriate.
• Oversee the Claims Department master list of groups and cases, including contractual claims service parameters.
• Manage client account assignments based on team and individual workload volume, when applicable.
• Manage and oversee the Claims Department filing process for Stop Loss Claims.
• Provide oversight and support for complex, high-priority claim submissions and guide the team on claims, correspondence, and processes.
• Conduct claim reviews and process reimbursement filing and reporting to Stop Loss carriers, when applicable or needed.
• Manage and produce monthly claims reporting and notifications to Stop Loss carriers, when applicable or needed.
• Support development and implementation of policies, procedures, and process improvements for Claims operations.
• Collaborate with the Director of Claims to support consistent, high-quality client service.
• Build collaborative relationships with internal departments and team members, as well as external carriers, brokers, consultants, and administrators.
• Partner with Claims Trainer(s) to identify skill gaps, coordinate training, and support team member participation and development.
• Perform other duties and projects as assigned.

Benefits

• Medical, dental, and vision coverage available on the first day of employment.
• Choice of medical plans through Blue Cross Blue Shield; Kaiser available for California employees.
• Virtual therapy, digital coaching, and 24/7 EAP counseling.
• Company-paid Basic Life and AD&D Insurance, Short-Term Disability, and Employee Assistance Program.
• Health Savings Account with company contributions.
• Health Care FSA, Dependent Care FSA, and commuter benefits.
• Parental leave and adoption assistance.
• Voluntary life insurance, critical illness, accident, and identity theft protection coverage.
• Retiree medical benefits available for Medicare-eligible retirees.
• 401(k) with company match.
• Generous paid time off and company holiday schedule.
• Collaborative, continuing-education-focused work environment.
• Career advancement opportunities.
• Annual performance-based bonus program.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed