Claims Operations Manager (Hybrid in Helena, MT)

Job description

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary: The Claims Operations Manager is responsible for overseeing and managing the daily operations of the claims department. This role requires candidates to reside locally in the Helena, MT area to accommodate our hybrid work model. This role is pivotal in managing healthcare claims processing operations, including overseeing the receipt, adjudication, calculation, payment, and reporting of claims submitted by providers. The position ensures all activities are completed in compliance with contractual requirements, relevant laws and regulations, and established claims policies and pro...