Claims Manager

Optima Health is seeking an experienced Claims Manager.

This is a full-time position.

Bachelor’s Degree required.

3 years experience working with health plans claims disbursements required.

Excellent Benefits and Competitive Wages!

Claims Manager is responsible for sustaining and developing departmental policies and procedures, providing oversight to staff responsible for claims processing activities, and ensuring that the organizationÂżs service, quality, productivity, and financial standards or goals are achieved. Oversee high dollar, complex claims auditing, monitor claims interest, perform detailed claims analyses and compose correspondence and/or detailed reports. Monitor and oversee direct reports to include Team Coordinators and employees. Assist with internal and external audits by thoroughly analyzing all errors and grievances. Create new claims policies or make recommendations to existing policies in the Claims P&P

Education Level
Bachelor’s Level Degree

Experience
Required: Related – 3 years

Preferred: None, unless noted in the “Other” section below

License
None, unless noted in the “Other” section below

Skills
Required:

Preferred: None, unless noted in the “Other” section below

Other
3 years of health plans claims disbursements required. Applicants who do not have their BachelorÂżs Degree will be required to sign a BachelorÂżs Degree agreement committing to successfully obtain their Bachelors within 5 years of hire.