Independence Blue Cross · 1 day ago
Mgr Claims Optns
Philadelphia, PA
Full-time
Onsite
Mid, Senior Level
5+ years expIndependence Blue Cross is seeking a Manager of Claims Operations to oversee associates in the claims processing department. The role involves ensuring cost-effective and quality operations while representing the company in audits and legal matters, managing compliance tasks, and maintaining performance standards.
Health CareHealth InsuranceInsuranceMedical
Responsibilities
Represents IBX in group and government audits and legal matters in a business capacity
Maintains oversight vendor activities
Handle compliance, regulatory and delegation tasks, including meetings
Achieve and maintain performance standards for the department in accordance with BCBSA and PA & NJ requirements
Evaluate the effectiveness and efficiency of operational areas and take action to reallocate resources as necessary
Manage work processes, measure non-conformance and identify corporate and department policies and procedures to achieve operational efficiencies
Interpret, communicate, and implement corporate and department policies and procedures
Maintain positive working relationships with internal and external customers to resolve departmental issues
Approve special consideration and handling for customers as appropriate
Compile and prepare required data pertaining to unit performance, budget, training, surveys, projects, audits, attendance, etc
Identifies the support and implementation of process improvements that impact overall service and reduces overall costs
Qualification
Required
A high school diploma or equivalent is required
5 years' experience in a health care or related setting, with two years in a leadership capacity
Comprehensive knowledge of claims operations, including processes, regulations, and best practices
Excellent interpersonal and leadership skills to effectively interact with direct reports, internal teams, and external customers
Strong organizational skills and attention to detail in a fast-paced environment that change frequently
Problem-solving ability to identify issues, develop resolutions, and educate customers on solutions
Exceptional communication skills with the ability to engage and convey information clearly across all levels of the organization
Company
Independence Blue Cross
The leading health insurer in southeastern Pennsylvania. It is a sub-organization of Independence Blue Cross.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Alexandra Jorgensen
Senior Vice President Human Resources
Joe Geist
SVP & Market President, National
Recent News
Home Health Care News
2026-01-14
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