Manager, Complex Claims - Remote

Overview

The Manager, Complex Claims is responsible for the engagement, development, and results of a team driving Claims Production Processing, ensuring that Oscar members' claims are processed in a timely and accurate manner.

In Short

• Lead a team to adjudicate complex claims efficiently.
• Conduct detailed analysis and reporting on claims trends.
• Ensure compliance with all applicable laws and regulations.
• Foster team development and leadership skills.
• Implement best practices for claims processing.
• Utilize data-driven approaches for operational improvements.
• Achieve production goals and performance objectives.
• Conduct file reviews for accuracy.
• Participate in employee benefits and unlimited vacation program.
• Work in a blended remote and in-office environment.

Requirements

• Bachelor's degree or equivalent experience.
• 4+ years of experience in healthcare claims management.
• 3+ years of experience in data analysis and problem-solving.
• Experience leading teams in a remote environment is a plus.
• Proficiency in Microsoft Office Suite.
• Process Improvement or Lean Six Sigma training preferred.

Benefits

• Competitive salary range based on location.
• Comprehensive medical, dental, and vision benefits.
• 11 paid holidays and paid sick time.
• Paid parental leave and 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.