DevotedHiring

Claims Configuration Senior Manager

  • Remote, United States
  • Lead
  • Posted 3 days ago
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In one line

Senior role owning the rules that decide how insurance claims get paid automatically or sent for manual review, plus the explanations members and providers receive.

About the role

The team works on paying claims correctly and on time, and on explaining those outcomes clearly. This person owns the accuracy and direction of the claims back-end logic and fixes problems at the root.

At a glance

Pay
Not stated in the posting
Remote scope
Remote, United States
Seniority
Lead
Skills
Claims adjudication, Contract group matching, EOB, EOP, 835/ERA, Root cause analysis, KPIs
Posted
26 Oct 2026
Last checked
27 Oct 2026

What you will do

  • Own the auto-adjudication rate and judge which pend flags still earn their cost
  • Resolve provider contract and contract group matching errors that cause wrong payments
  • Own the logic behind member and provider payment explanations and remittance outputs

What they look for

  • Six or more years in business operations or operational leadership
  • Comfort with ambiguity and willingness to dig into complex claims system logic
  • A detail-oriented problem solver who traces a claim from intake to payment

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Questions about this job

Can I do this job remotely, and from which countries?

Yes. The posting lists Claims Configuration Senior Manager as a remote role for candidates in the United States.

What does this job pay?

No pay range is stated in the posting.

What experience is needed?

It is a lead role. The posting asks for: six or more years in business operations or operational leadership; comfort with ambiguity and willingness to dig into complex claims system logic; a detail-oriented problem solver who traces a claim from intake to payment. Skills it names include Claims adjudication, Contract group matching, EOB, EOP.

How do I apply with Keywordise AI?

Select Apply with Keywordise AI, sign up and upload your CV. Keywordise writes a CV and a cover letter for this job from your real experience and applies for you. The 7-day free trial needs no card.

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