Manager, Claims (Health Insurance)

Location: Remote Flex - North Carolina

Salary: $107,901–$172,642 annually

Company

hirify.global delivers health care coverage and services with a strong focus on community health.

What you will do

• Implement an end-to-end claims service model across provider and customer segments.
• Manage claims submission, refunds, collections, recovery, appeals, and financial processing across lines of business.
• Oversee claims accounting, financial reporting, data preparation, analysis, and reconciliation.
• Set operational performance and process targets, streamline shared processing, and improve customer satisfaction.
• Lead team leads and staff while managing workload, utilization, engagement, accuracy, and quality.
• Act as the ASO Claims subject matter expert and escalation point for internal stakeholders, clients, and ASO executives.

Requirements

• Must work remotely from North Carolina.
• Bachelor’s degree or advanced degree where required.
• 8+ years of experience in a related field, or 10+ years in lieu of a degree.
• Experience with claims management, claims processing, financial processing, and claims resolution.
• Experience managing people and collaborating with Finance, Audit, Payment Integrity, Sales, and customer stakeholders.

Nice to have

• Claims operations experience in a regulated environment such as Medicare or government programs.
• Experience leading claims teams and managing performance.
• Understanding of claims systems and processing workflows.
• Data analytics and reporting experience.
• Experience with Facets or a similar claims platform.

Culture & Benefits

• Work-life balance, flexibility, and autonomy.
• Medical, dental, and vision coverage with health and wellness programs.
• Parental leave, adoption assistance, and surrogacy assistance.
• Career development programs and tuition reimbursement.
• 401(k) match and annual company contribution.
• Annual incentive bonus based on corporate goal achievement and individual performance.