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Claims Advocacy Manager

Bluffton, IN 46714 | Fully Remote

Employment Type: Direct Hire Category: Help Desk / Desktop Support Job Number: 25775 Pay Rate: 85.00

Job Description

Claims Advocacy Manager

Location: Bluffton, Indiana
Position Type: Direct Hire
Hourly / Salary: Based on Experience
Residency Status: US Citizen or Green Card Holder ONLY

Our client is looking for a Claims Advocacy Manager to join their team!

Job Description

The Claims Advocacy Manager is responsible for assessing and improving performance within the Claims Department and assisting the Director of Claims with implementing policies and procedures that guide and support service levels. This Role will proactively manage the Claims Advocacy team responsible for multifaceted claim issue resolution and complex specialty claims. The Claims Manager will report to the Director of Claims.


• Responsible for the overall operations and performance of the Claims Advocacy team, including but not limited to, recommendations on placement/promotions, annual performance evaluations, and disciplinary actions.
 • Develop positive and collaborative relationships with both internal and external stakeholders to ensure efficient and effective service delivery.
 • Research and resolve escalated claim issues assigned to the Claims Advocacy team.
 • Assist with overall management of product add on’s, including but not limited to Gene Therapy Solutions as well as other programs developed and determined appropriate.
 • Manage and distribute workload within Advocacy team based upon review of volume.
 • Provide subject matter expertise and technical guidance to Claims team members and/or other internal partners on complex claim issues.
 • Assist with the development and implementation of policies and procedures for efficient and effective Claims Advocacy team operations.
 • Develop, consult, and implement training programs regarding specialty claim issues and assist with training as needed.
 • Other duties and projects as assigned.


• 3-5 years of equivalent work experience in Claims, Stop Loss, Ancillary or TPA environment preferred but not required.
 • 3-5 years of management experience preferred but not required.
 • Proven ability to effectively manage time, prioritize workload and meet deadlines.
 • Strong teamwork skills: ability to work cooperatively and jointly with staff members.
 • Excellent communication skills, written and verbal, with both internal and external parties.
 • Sense of urgency and attention to detail are necessities.
 • Proficiency in Microsoft Office programs including Word, Excel, Outlook, Teams etc.
 • Ability to maintain strict confidentiality.

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