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, financial impact, etc.

• Collaborate with other departments to integrate best practices and enhance overall operational efficiency

• Maintain and report on staffing analytics

• Other duties as assigned

Qualifications:

• Minimum of 2+ years of experience in health insurance claims management, with a preference of 10+ years of health insurance experience

• Strong understanding of health insurance claims processing, procedures, and regulatory requirements

• Excellent leadership and interpersonal skills with a proven track record of effective communication and relationship-building with team members, stakeholders, and clients

• Strong analytical and problem-solving abilities

• Ability to work both independently and within a team as a contributor and leader in a fast-paced, changing environment

Bonus Points

• Experienced in building plans within the VBA Software claims processing system

• Experience working for a startup

• Understanding of electronic claim exchanges and network routing

• Bachelor's degree, or equivalent work experience

The salary range for this job opportunity is $70,000 to $120,000 per year, which is the amount Angle Health anticipates paying for this position at the time of this job posting. The actual base salary offered may differ and will depend on various factors such as geographic location, skills, qualifications, and experience, as well as internal equity.

Because We Value You:

• Competitive compensation and stock options 

• 100% company-paid comprehensive health, vision & dental insurance for you and your dependents 

• Supplemental Life, AD&D and Short-Term Disability coverage options 

• Discretionary time off 

• Opportunity for rapid career progression 

• Relocation assistance (if relocation is required) 

• 3 months of paid parental leave and flexible return to work policy (after 10 months of employment) 

• Work-from-home stipend for remote employees 

• Company provided lunch for in-office employees 

• 401(k) account 

• Other benefits are coming soon! 

Backed by a team of world class investors, we are a healthcare startup on a mission to make our health system more effective, accessible, and affordable to everyone. From running large hospitals and health plans to serving on federal healthcare advisory boards to solving the world's hardest problems at Palantir, our team has done it all. As part of this core group at Angle Health, you will have the right balance of support and autonomy to grow both personally and professionally and the opportunity to own large parts of the business and scale with the company. 

Angle Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Angle Health is committed to working with and providing reasonable accommodations to applicants with physical and mental disabilities.