Health Claims Manager

Oversee the processing, evaluation, and resolution of health insurance claims. Ensure that claims are handled accurately and efficiently, in compliance with policies, regulations, and industry standards.

Experience:  7-10 years' experience in claims management or related field and proven track record of managing a claims department.  Experience in leading, training and mentoring of claims officers.

Skills:  Strong analytical and problem-solving, Excellent written and verbal communication, Ability to interpret insurance policies, terms and conditions and underwriting guidelines, Experience in handling complex medical claims.

Additional Skills: Strong negotiation, conflict resolution, organizational and time management skills.  Ability to build and maintain relationships with clients, service providers and internal stakeholders.  

Responsibilities: 

• Team Management
• Claims Processing
• Quality Control
• Reporting and Analysis
• Customer and Provider Relations