Claims Manager

Changing Healthcare For Good

At Angle Health, we believe the healthcare system should be accessible, transparent, and easy to navigate. As a digital-first, data-driven health plan, we are replacing legacy systems with modern infrastructure to deliver our members the care they need when they need it. If you want to build the future of healthcare, we'd love for you to join us.

We are excited to grow our Operations team at Angle Health and are looking to bring on a new team member. We’re seeking a highly motivated individual with strong claims processing and management experience who wants to disrupt the health insurance industry. The Claims Manager’s responsibilities include oversight and management of the Claims department to ensure accurate, efficient, and timely handling of all health insurance claims. This role involves supervising a team of claims processors, adjusters, auditors, and appeal coordinators, developing and implementing claims management strategies and Standard Operating Procedures (SOPs), and ensuring compliance with relevant regulations and policies.

Successful candidates will have a passion for health insurance, superior claim processing and analytical skills, bias toward action, and exceptional leadership and communication skills. We move quickly as a team to drive company-wide decisions, thus a balance of getting the details right while still moving fast is important. Finally, we want someone who wants to learn and grow as we’re looking for a candidate who is motivated to advance.

Core Responsibilities:

• Supervise and mentor a team of claim processors, adjusters, auditors, and appeal coordinators

• Conduct performance evaluations and provide training and coaching when necessary

• Foster a positive and productive work environment with the ability to motivate and guide team members, resolve conflicts, and address performance issues in a constructive manner

• Oversee the processing of health insurance claims and appeals to ensure accuracy and adherence to company policies and procedures, as well as state and federal regulations

• Review and audit high dollar and complex claims and resolve escalated issues

• Monitor claim trends, utilizing data to target and implement process improvements to enhance efficiencies and reduce errors

• Stay updated on changes in health insurance laws and regulations to ensure ongoing compliance

• Work closely with the Care Team to ensure routed service tickets and escalations are handled timely and with a high level of satisfaction, addressing and resolving customer complaints

• Prepare, track, and analyze reports on claim performance, including but not limited to daily inventory; monitoring metrics related to processing times, accuracy, …