Claims Manager

Do you want to make a difference?

Do you want to help patients on their healthcare journey?

Are you a patient advocate?

If “Yes”, then Patient Advocates may be your life’s work.

Patient Advocates has an opening for a results driven Claims Manager looking to be part of a culture built on the passion for revolutionizing Healthcare.

Patient Advocates is an innovative Third-Party Administrator (TPA) that has been partnering with New England businesses for more than 20 years, and we are leading the charge to change the healthcare system one patient at a time. Our clients and members are at the heart of all that we do. As such, we offer patient advocacy, diabetes/chronic disease management, and other creative solutions to help meet our client’s healthcare needs. Additionally, we work side-by-side with our members at every step of their journey to ensure that we maximize their healthcare value and experience. Our success is only possible with the help of our knowledgeable and committed staff who work diligently to build and maintain relationships with our clients, members and care providers.

Our business is growing and now is your opportunity to become part of our energetic, compassionate & collaborative team. Apply today!

Job Description

The Claims Manager performs all the activities needed to maintain high productivity in employees. The Claims Manager works in operations where he/she ensures staff optimization including productivity and quality assurance, maintains employee scorecards and facilitates effective communication among the team.

Job Requirements

Goal setting- the Claims Manager supports setting performance goals for individual employees and the team to ensure best in class performance. Setting goals helps improve employee focus and determination. The Claims Manager position coordinates numerous activities designed to improve the productivity and accuracy of employees, including training, and performance input. The Claims Manager establishes appropriate and transparent systems for performing this task.

· Coordination Across Departments- this position ensures activities across departments are coordinated to ensure corporate goals are achieved This includes, but is not limited to: high dollar claim review, timely processing of reinsurance claims, customer service inquiries and projects impacting multiple claims.

• Collaboration- collaborates with IT and Configuration to develop reports which support claims activities and ensure we have sight on our end-to-end processes.
• Enhancing Communication- In a workplace environment where numerous people with different personalities interact daily, the Claims Manager must promote effective communication to achieve improved productivity, timeliness and quality. This professional must work with other department heads to create an interactive communication system that promotes openness and minimizes workplace conflicts.
• Maintaining records- the Claims Manager updates and maintains productivity, quality and attendance records via a monthly scorecard for individuals and KPIs for leadership.
• Ability to work weekends as needed
• Other duties as assigned

Minimum Qualifications and Skills Needed

· A bachelor’s degree in business administration or human resources management preferred

· Minimum of 10 years claims operations experience

· Prior claims processing, training and quality assurance experience

Required Skills:

· Great communication skills

· Attention to detail

· Ability to train and motivate staff

· Proven ability to make data driven decisions

· Teamwork

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Schedule:

• Monday to Friday

Education:

• Bachelor's (Preferred)

Experience:

• Claims Processing: 3 years (Preferred)

Work Location: One location