Angle Health
Claims Manager
Angle Health, California, Missouri, United States, 65018
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!
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.
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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!
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.
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