Centerwell Senior Primary Care

Healthcare

Manager,ClaimsProcessing

$78–108k Miramar, Florida, United States FULL TIME
The Brief

“Manager, Claims Processing at Centerwell Senior Primary Care. Skills: Claims processing, People management, Process improvement, Compliance. Oversee claims adjudication and resolution. Ensure compliance with payer guidelines”

What You'll Achieve.

timely, accurate, and compliant processing; optimize workflows; improve departmental performance; department goals; productivity metrics; accuracy standards; service-level agreements; improve claims processing efficiency; denial rates; turnaround times; cash flow; address root causes; revenue cycle outcomes; payer compliance; operational stability; revenue cycle effectiveness

Industry & Context.

Healthcare
Problems you'll solve

advanced technical knowledge; advanced analysis; independent judgment; analytical skills

What They're Looking For.

Must Have

Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field, or equivalent combination of education and experience, 5 + years of progressive experience in claims processing, billing, or revenue cycle management within home health, DME, home infusion, SNF or related healthcare settings, 2 or more years of people management experience, Comprehensive knowledge of all Microsoft Office applications, including Word, Project and Visio, working knowledge of Medicare, Medicaid, and commercial insurance reimbursement, EDI claims, and healthcare billing systems

Nice to Have

Project Management experience, Six Sigma certification

What You'll Do.

Oversee claims adjudication and resolution

Ensure compliance with payer guidelines

Determine claim payment or denial

Manage escalated claims issues

Manage and develop claims professionals

Coordinate team activities

Identify staffing and training needs

Implement change initiatives

Analyze claims trends

Solve operational and technical problems

Collaborate with other teams

Maintain contact with peer managers

Participate in cross-department meetings

Ensure adherence to regulations

Support internal and external audits

How You'll Work.

Team & Collaboration

Collaborate with Coding, Clinical Operations, Intake, Authorization, Finance, and Compliance teams; Maintain frequent contact with peer managers and senior professionals; Participate in cross-department meetings, briefings, and audits

Communication Scope

Communicates effectively with internal stakeholders and external payer representatives

Process & Methodology

Project Management experience

Free ATS check

Applying for this Manager, Claims Processing role?

Most applicants get filtered before a human reads their resume. See if yours makes the cut.

How to Apply on Workday

  • Workday has a multi-step form — save your progress after every section.
  • "Apply With LinkedIn" can fail or lose data; manual entry is more reliable.
  • Watch for the "Submit for Review" final step — hitting "Save" alone does not submit.
  • Job requisition numbers are useful when following up with HR by email.

ANONYMOUS · UNFILTERED

What do employees actually say about Centerwell Senior Primary Care?

Real rants from real employees. Read before you apply.

Read Company Rants →