⚡ Claims Operations Manager

🎯 Fertility Employee Benefits Technology

🌎 Remote, Travel may be required

💸 $110K – $160K + Bonus

Storm3 is working with a well-known fertility benefits company that makes a lasting impact on families through the whole journey – from pre-conception and fertility to parenting. Their mission is to provide high-quality care throughout the whole family solution experience. The company is looking to expand its sales team. The role is an independent contributor who has experience in selling into enterprise accounts and managing relationships with HR and decision-makers. An ideal candidate is someone who has experience in selling to HR leaders and decision-makers with 8+ years of experience.

Qualifications/Requirements:

• Experience in Health Plan Claims
• Management experience
• HIPAA, ICD-10, NDC/GPI, & CPT/HCPCS coding knowledge
• Strong performance management and productivity optimization skills, including reporting, analysis and recommendations.

Responsibilities:

• Plans, organizes and manages key claim functions.
• Monitors and tracks staff and department performance against established productivity and quality metrics, including regular audits assessing department performance. Identifies and acts on both positive and negative performance trends to ensure attainment of goals.
• Oversees day-to-day claims operations, including claims evaluation, adjudication and customer service in accordance with contract and Company quality and production standards.
• Reviews claim audits for completeness, accuracy of information and compliance with WIN’s policies, standards and procedures. Resolves any issues or directs claim to team lead/area manager for resolution prior to payment.

Benefits:

• Salary $110K – $160K
• Bonus
• Remote environment with travel
• Competitive PTO
• Health benefits option
• Wellness benefits
• Competitive bonus structure, depending on performance.

📧 Interested in applying? Please click on the ‘Easy Apply’ button or for a confidential chat – mohamed.salah@storm3.com

⚡ Storm3 is a HealthTech recruitment firm with clients across London, Europe and North America. To discuss open opportunities or career options, please visit our website www.storm3.com and follow the Storm3 Linked In page for the latest jobs and intel