Sr. Manager - Claims
Astrana Health, Inc. • Monterey Park, CA112d • $125,000 - $140,000 • Hybrid
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Sr. Manager - Claims
Astrana Health, Inc.•Monterey Park, CA
•$125,000 - $140,000•Hybrid
About The Position
We’re looking for a Claims Operations leader who enjoys balancing people leadership with operational execution. In this role, you’ll oversee daily claims processing, drive quality and turnaround time performance, and support the onboarding of new IPAs and implementations. You’ll partner closely with internal teams, resolve escalations, and coach a team of claims professionals to deliver compliant, efficient, and accurate outcomes in a fast‑paced environment.
Requirements
- Minimum of a Bachelor's degree (B.A.) from a four-year college or university; or at least four (4) years current Management or equivalent experience with an MSO or IPA Management
- Full knowledge of DMHC, DHS and CMS Regulations and Guidelines, ICD-10, CPT, RV/RBRVS codes
- Experience with contract law and Division Responsibility matrix interpretation
- Comprehensive knowledge in the AB1455 regulations
Nice To Haves
- EZCAP experience is a plus
- Master's degree or healthcare certifications
Responsibilities
- Lead daily claims operations to ensure quality, accuracy, and timely processing
- Manage claims inventory and prioritize workloads to consistently meet SLAs
- Support onboarding and implementation of new IPAs and claims operations
- Drive continuous improvement initiatives to increase claims efficiency and quality
- Resolve claims processing issues and escalations across assigned teams and IPAs
- Use claims systems and reports to monitor performance and share insights with leadership
- Coach, train, and develop claims staff (including offshore teams) to meet performance expectations
- Partner with internal teams on system updates, process improvements, and compliance needs
- Handle sensitive provider/member inquiries and high‑level claim issues as needed
- Other duties as assigned
Benefits
- Equal Employment Opportunity
- Affirmative Action
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What This Job Offers
Job Type
Full-time
Career Level
Manager
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