Operations Manager — $0 Healthcare for You and Your Entire Family
About The Position
The Claims Manager exists to lead a high-performing team that helps members navigate billing, reimbursement, and claims challenges with clarity and confidence. This is a hands-on leadership role for someone who thrives in building and leading strong teams, enjoys solving complex operational and billing challenges, and keeps the member experience at the center of every decision. The role involves owning team performance, structure, and daily operations of the Claims function, leading team development, coaching, goal-setting, and performance management. It also includes overseeing the full lifecycle of provider claims, ensuring compliance with plan benefits and regulatory requirements, supporting members directly with escalated issues, collaborating with internal teams, improving processes, and tracking performance through KPIs.
Requirements
- 5+ years in a supervisory or managerial role
- Proven leadership skills and operational excellence
- Strong communication and analytical thinking skills
- A customer-first mindset with a passion for solving complex problems
- A hands-on, collaborative leadership approach
Nice To Haves
- Experience in healthcare billing, reimbursement, or claims (Preferred)
Responsibilities
- Lead and develop the Claims team to deliver exceptional member support
- Oversee claims operations while ensuring accuracy, compliance, and efficiency
- Drive scalable processes and partner cross-functionally to improve outcomes
- Own: Team performance, structure, and daily operations of the Claims function
- Lead: Team development, coaching, goal-setting, and performance management
- Oversee: The full lifecycle of provider claims including submissions, adjudication, appeals, and dispute resolution
- Ensure: Compliance with plan benefits, regulatory requirements, and internal SOPs through audits and oversight
- Support: Members directly with escalated billing and claims issues, providing clear and empathetic communication
- Collaborate with: Internal teams including Claims, Care Logistics, and Client Success to ensure seamless coordination and resolution
- Improve: Processes, workflows, and outcomes by identifying trends and reducing repeat issues
- Track: Performance through KPIs such as speed to process, appeals rates, and negotiation success
Benefits
- FREE healthcare for you and your entire family
- Dental & Vision insurance
- Paid time off & sick time
- 401(k) access
- A mission-driven team that believes in doing the right thing
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
Number of Employees
11-50 employees
