Talantix.io
Captrue Benefits•04.03.26
AI SCORE 8.2

Remote Claims Manager - Healthcare Focus

$80K–$100K/year
RemoteHealthcare Claims Management
Claims Management•Healthcare Compliance•Data Analysis•Team Leadership•Process Improvement•VBA Software

About the Role

We are seeking a dedicated and experienced Remote Claims Manager to join our innovative healthcare team. As a Remote Claims Manager, you will play a crucial role in overseeing the claims process, ensuring compliance with healthcare regulations, and improving operational efficiency. This position offers the opportunity to work remotely while making a significant impact on how healthcare is financed and delivered.

What You'll Do

  • Manage and oversee the claims processing operations, ensuring adherence to ERISA and HIPAA compliance.
  • Lead a team of claims analysts and support staff, fostering a collaborative and productive work environment.
  • Implement process improvements to enhance the efficiency of claims management.
  • Conduct data analysis to identify trends and areas for improvement in claims processing.
  • Collaborate with internal and external stakeholders to resolve complex claims issues.

Requirements

  • 3-5 years of experience in claims management within the healthcare industry.
  • Strong knowledge of healthcare regulations, including ERISA and HIPAA.
  • Proficient in claims coding structures and medical claims analysis.
  • Excellent leadership and team management skills.
  • Strong analytical skills with experience in data analysis and process improvement.

Nice to Have

  • Experience with VBA software for claims systems.
  • Familiarity with auto insurance and liability determinations.
  • Previous experience in commercial trucking claims management.

What We Offer

  • A supportive, innovative, and collaborative work culture.
  • Opportunities for professional development and training.
  • Engagement in continuous improvement initiatives.
  • Flexible remote work arrangements.
  • Competitive salary and benefits package.
Why This Job8.2 of 10

This Remote Claims Manager position offers a unique opportunity to lead claims processes in a supportive healthcare environment. Enjoy competitive pay and professional growth.

Salary Range
Required
0/1
Optional
0/1
Bonus
0/1

Who Will Succeed Here

→

Strong proficiency in claims management processes and healthcare compliance, specifically with knowledge of HIPAA regulations and the ability to analyze claims data using tools like Excel and VBA for process optimization.

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Self-motivated and organized individual who thrives in a remote work environment, demonstrating excellent time management skills and the ability to lead virtual teams effectively while fostering collaboration and accountability.

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Analytical mindset with a focus on continuous improvement, capable of identifying inefficiencies in claims processes and implementing data-driven solutions to enhance operational performance and reduce turnaround times.

Learning Resources

→Healthcare Claims Management: A Complete Guideguide
→Healthcare Compliance Trainingcourse
→Data Analysis with Excel and VBAcourse

Career Path

Remote Claims Manager - Healthcare Focus(Now)→Claims Operations Director(1-2 years)→Vice President of Healthcare Claims Management(3-5 years)

Market Overview

Market Size 2024
$23.5B
Annual Growth
12.3%
AI Adoption
45%
Investment in Healthcare Tech
+30%
Labour Demand for Claims Managers
+15%
Avg Salary
$85K

Skills & Requirements

Required
Claims ManagementHealthcare ComplianceData Analysis
Growing in Demand
Health Information Technology (HIT)Predictive AnalyticsRobotic Process Automation (RPA)
Declining
Manual Claims ProcessingBasic Excel Reporting

Domain Trends

Increased Automation in Claims Processing
Over 60% of healthcare organizations are adopting automation tools to streamline claims processing, reducing processing time by up to 40%.
Shift to Value-Based Care
By 2025, it is projected that 70% of healthcare payments will be tied to value-based care models, increasing the demand for skilled claims managers who can navigate these complexities.
Data-Driven Decision Making
Healthcare organizations that leverage data analytics for claims management report a 25% increase in operational efficiency and a 20% reduction in claim denials.

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