Sr. Manager Claims (Remote)

Responsibilities

• Ensures AMAI remains in compliance with all claims related processing; must adhere to all carrier and/or state regulatory requirements with regards to timeliness, accuracy, and payments.
• Serves as Agency subject matter expert and primary point of contact for all claims related functions; working closely with internal and external business partners.
• Responsible for process improvement and the development and utilization of key processing metrics.
• Manages team of claims processors.

Requirements

• Bachelor's degree preferred or equivalent work experience and HS diploma/equivalent education required.
• 7+ years experience in health claims management.
• Experience in people management required; able to attract and develop talent.
• Proven claims experience with multiple products including Medicare Supplement, major medical, hospital indemnity, life and disability insurance required.
• Expert knowledge of medical terminology, ICD-9/ICD-10 codes, CPT/HCPCS and revenue codes required.
• In-depth understanding of claims systems and electronic processing of medical claims (HIPAA ANSI 5010 electronic transactions) and imaging systems required.
• Excellent organizational skills and attention to detail with the ability to manage multiple priorities and meet deadlines.
• Ability to make sound judgments using strong critical thinking, analytical, research and problem-solving skills.
• Demonstrated sense of discretion when handling confidential information.
• Ability to effectively present information and respond to questions from staff, management, plan participants and business partners, using excellent verbal and written communications skills including creating and writing reports, business correspondence and procedure manuals.

Qualifications

This role is an exempt position, and the salary range for this position is $104,872 - $138,737. This is the lowest to highest salary we believe we would pay for this role at the time of this posting. An employee’s pay within the salary range will be determined by a variety of factors including but not limited to business consideration and geographical location, as well as candidate qualifications, such as skills, education, and experience.

Employees are also eligible to participate in an incentive plan.

To learn more about the American Medical Association’s benefits offerings, please click here.

We are an equal opportunity employer, committed to diversity in our workforce . All qualified applicants will receive consideration for employment . As an EOE/AA employer, the American Medical Association will not discriminate in its employment practices due to an applicant’s race, color, religion, sex, age, national origin, sexual orientation, gender identity and veteran or disability status.