Medical Claims Operations Manager
4 weeks ago
At SmithRx, we're revolutionizing the Pharmacy Benefit Management (PBM) sector with cutting-edge technology and innovative cost-saving tools. As a Medical Claims Operations Manager, you'll play a pivotal role in our mission to transform the healthcare system.
As a key member of our Patient Access Programs Team, you'll oversee the operational performance and efficiency of our team responsible for procuring medications through drug manufacturers. Your team serves as our patients' advocate, guiding them through the complex world of prescriptions to obtain medications in a cost-effective and timely manner.
Key responsibilities include:
- Directly managing, coaching, and mentoring a team of patient advocates
- Leading training and onboarding for new team members
- Providing day-to-day supervision, support, and escalation path for patient advocates
- Leading the team to meet patient advocate team target KPIs
- Ensuring efficient allocation of operational center resources and maintaining high-performance standards
- Identifying and driving areas for operational process improvements to support efficiency and scale
Requirements include:
- At least 5 years of management experience in a healthcare setting leading teams in operations and/or customer service
- Experience managing Team Leads and/or Managers required
- HS diploma or GED or equivalent work experience
- Previous experience helping patients/members with healthcare
- Passion for mentoring and helping team members with career pathing and skills enhancement
- Previous experience with healthcare, pharmacy benefits, and/or claims processing a plus
We offer a highly competitive wellness benefits package, including Medical, Pharmacy, Dental, Vision, and Life Insurance, as well as Flexible Spending Benefits, 401(k) Retirement Savings Program, Short-term and long-term disability, 12 Paid Holidays, Employee Assistance Program, and a well-stocked kitchen in office locations.
-
Freight Claims Specialist
4 weeks ago
Plano, Texas, United States CEF Solutions Inc Full timeCareer Opportunity: Freight Claims Specialist at CEF Solutions Inc.Cef Solutions Inc. is a Consulting Services and Business Process Outsourcing (BPO) company specializing in BPO Operations, Operations Management, Process Engineering and Innovation, Cost Optimization, and Staffing solutions.We take pride in our expertise in providing specialized staffing...
-
Cargo Claims Specialist
4 weeks ago
Plano, Texas, United States Crystal Equation Full timeCargo Claims SpecialistAt Crystal Equation, we are seeking a skilled Cargo Claims Specialist to join our team. The ideal candidate will have a strong background in freight claims processing and a keen eye for detail.Responsibilities:• Review new submissions to ensure all required documentation and claim details are included• File and manage shortage...
-
Title Insurance Claims Specialist
4 weeks ago
Plano, Texas, United States TEEMA - Litchfield Park Full timeJob SummaryWe are seeking a skilled Title Insurance Claims Administrator to join our team at TEEMA - Litchfield Park. The successful candidate will be responsible for managing and processing title insurance claims efficiently and accurately, ensuring timely resolution and exceptional customer service.Key Responsibilities:Handle all aspects of title insurance...
-
Insurance Claims Examiner
4 weeks ago
Plano, Texas, United States Liberty Mutual Group Full timeJob SummaryWe are seeking a skilled Claims Specialist I to join our team at Liberty Mutual Group. As a Claims Specialist I, you will be responsible for managing, investigating, and resolving unrepresented Bodily Injury & Property Damage claims.Key ResponsibilitiesInvestigate and evaluate coverage, liability, damages, and settle claims within prescribed...
-
Insurance Claims Examiner
1 month ago
Plano, Texas, United States Liberty Mutual Group Full timeJob SummaryWe are seeking a skilled Insurance Claims Examiner to join our team at Liberty Mutual Group. As a key member of our claims team, you will be responsible for managing an inventory of claims to evaluate compensability and liability.Key ResponsibilitiesEvaluate claims to determine compensability and liabilityEstablish action plans based on case...
-
Senior Claims Resolution Specialist II, Casualty
4 weeks ago
Plano, Texas, United States Liberty Mutual Full timeJob SummaryWe are seeking a highly skilled Claims Resolution Specialist II to join our team at Liberty Mutual. This role is responsible for investigating, evaluating, and resolving claims in a timely and professional manner.Key ResponsibilitiesInvestigate and evaluate claims to determine liability and damagesCommunicate with policyholders, witnesses, and...
-
Global Claims Expert
4 weeks ago
Plano, Texas, United States Sedgwick Full timeUnlock Your Potential in a Global Industry LeaderTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. As a skilled Claims Expert at Sedgwick, you will be part of a rapidly growing, industry-leading global company known for its excellence and customer service. Join us and contribute to Sedgwick...
-
Healthcare Operations Manager
4 weeks ago
Plano, Texas, United States Amare Medical Network Full timeNursing Department Supervisor Role at Amare Medical NetworkNurse managers are responsible for supervising nursing staff in a hospital or clinical setting. They oversee patient care, make management and budgetary decisions, set work schedules, coordinate meetings, and make decisions about personnel.Key Responsibilities: Oversee patient care and ensure...
-
Medical Spa Sales and Operations Director
1 month ago
Plano, Texas, United States DFW Medical Spa Full timeJob DescriptionWe are seeking a highly skilled Sales and Operations Manager to lead the day-to-day sales and operations of our medical spa and wellness center. This individual will be responsible for inventory management, customer complaints, announcements, facilitating morning huddles, and ensuring location success in sales and customer experiences.The...
-
Account Manager for Integrated Absence Solutions
3 weeks ago
Plano, Texas, United States Lockton, Inc. Full timeJob Summary:Lockton Companies is currently seeking a results-driven Account Manager to support the Integrated Absence Solutions (IAS) team. This role is responsible for delivering exceptional client service and supporting Lockton's IAS Select services with engagements that address the client's disability, life, and absence programs, including long term...
-
Medical Billing Specialist
1 month ago
Plano, Texas, United States TMS Neuro Solutions LLC Full timeJob Title: Medical Billing/Revenue CycleJob Summary:We are seeking a highly organized and detail-oriented Medical Billing/Revenue Cycle professional to join our team at TMS Neuro Solutions LLC. The successful candidate will be responsible for ensuring accurate and timely billing and revenue cycle management for our patients and providers.Key...
-
Medical Billing Specialist
4 weeks ago
Plano, Texas, United States DOCTORS OF INTERNAL MEDICINE Full timeJob Title: Medical Billing SpecialistJob Summary: We are seeking an experienced Medical Billing Specialist to join our team at DOCTORS OF INTERNAL MEDICINE. The ideal candidate will have a strong understanding of medical billing and coding, as well as excellent communication and organizational skills.Responsibilities:Charge Entry/Charge CaptureDenial...
-
Medical Billing Specialist
4 weeks ago
Plano, Texas, United States Private Label Staff Full timeJob SummaryA leading medical device company is seeking a temporary Medical Billing Collector with expertise in Durable Medical Equipment (DME), specifically in oxygen therapy. The ideal candidate will have experience working directly with physicians, reviewing medical documents, and ensuring that all records meet regulatory and company standards.Key...
-
Patient Access Programs Team Manager
4 weeks ago
Plano, Texas, United States SmithRx Full timeJob Summary: As a Manager for our Patient Access Programs Team, you will oversee the operational performance and efficiency of our team responsible for procuring medications through drug manufacturers. Your team serves as our patient members' advocate, guiding them through the complex world of prescriptions to help them obtain medications in a cost-effective...
-
Maxor Billing Specialist
4 weeks ago
Plano, Texas, United States Maxor Full timeJob SummaryWe are seeking a highly skilled Billing Specialist to join our team at Maxor. As a Billing Specialist, you will be responsible for preparing and submitting clean claims to third-party insurance carriers, Medicare, Medicaid, copay assistance programs, and foundations. This includes primary, secondary, and tertiary claims.You will also assist in...
-
Customer Service Representative
4 weeks ago
Plano, Texas, United States Brown & Brown Full timeBuilt on meritocracy, our company culture rewards self-starters and those who are committed to doing what is best for our customers. We are seeking a Customer Service Representative to assist callers with inquiries, complaints, or problems and provide an accurate and efficient response. This role will handle a high volume of inbound calls and strive to...
-
Guidewire Testing SME
4 weeks ago
Plano, Texas, United States Tekfortune Inc Full timeAt Tekfortune Inc, we are seeking a highly skilled Guidewire Testing SME to join our team. As a Guidewire Policy Center Testing Expert, you will be responsible for analyzing and identifying topics/events in Guidewire, analyzing API payloads for various operations/integration points, and arriving at a testing approach. You will also be responsible for...
-
Regional Operations Senior Manager
4 weeks ago
Plano, Texas, United States Samsung SDS America Full timeJob DescriptionSamsung SDS America is seeking a highly skilled Regional Operations Senior Manager to oversee the daily operations of its warehouses and ensure successful delivery of results, particularly in customer service and finance activities.The ideal candidate will have a strong background in logistics and freight forwarding, with experience working...
-
Sales Operations Manager
3 weeks ago
Plano, Texas, United States undisclosed Full timeAbout the RoleWe are seeking a highly motivated and entrepreneurial Sales Operations Manager to join our team at Align. As a key member of our Data Center Solutions group, you will be responsible for managing the day-to-day sales support operations in our Plano Office and collaborating with internal teams, customers, suppliers, and manufacturing...
-
Service Operations Manager
4 weeks ago
Plano, Texas, United States Tesla Full timeService Operations ManagerAt Tesla, our Service Managers are the front-line leaders of our service operation. They act as brand ambassadors, delivering an exceptional experience to customers, managing day-to-day operations, and proactively developing team members to reach their full potential.We hire leaders who want to run a service business and be a part...