Top 230 Claims manager Jobs in Alabama

Manager, Payment Integrity-COB/TPL /Subrogation
Centene —Alabama
- $87,700 - $157,800 a year
- Full-time
- Remote
- Management
- Mid-level
- Supervising experience
- Paid holidays
- Health insurance
2d
Medicaid Claims Operations Manager
General Dynamics Information Technology —Montgomery, AL
- $111,155 - $150,385 a year
- Hybrid work
- Background check
- 5 years
- Office
- Paid time off
- 401(k) matching
14d
Senior Program Manager / Project Manager - Medicaid Claims
CVS Health —Alabama
- $106,605 - $284,280 a year
- Full-time
- Remote
- Bachelor's degree
- Mentoring
- Fair chance
- Health insurance
- Dental insurance
PBM Call Center Manager - Remote US
Gainwell Technologies —Alabama
- $87,300 - $124,700 a year
- Full-time
- Remote
- HIPAA
- 3 years
- Analysis skills
- Travel reimbursement
- Profit sharing
7d
Operations Claims Processing Manager
Conduent State Healthcare, LLC —Montgomery, AL
- $77,770 - $101,000 a year
- Email
- Background check
- Computer Science
- Office
- Paid training
- Paid holidays
Sr. Manager, Pricing - Pharmacy Appeals
CVS Health —Alabama
- $67,900 - $182,549 a year
- Full-time
- Remote
- 7 years
- Microsoft Access
- Office
- Health insurance
- Dental insurance
Credentialing Manager
Pathway Healthcare Services LLC —Birmingham, AL
- Full-time
- 5 years
- Computer literacy
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
EHS Manager
Runergy Alabama Inc —Huntsville, AL
- Ability to walk for extended periods
- Mid-level
- Ability to lift 50 pounds
- Health insurance
Quick Apply
8d
General Manager - Transportation
Platform Waste Solutions —Decatur, AL
- $65,000 - $80,000 a year
- 8 hour shift
- CDL B
- English
- Windows
- Health savings account
- Relocation assistance
Quick Apply
Title Agency Operations Manager
Jubilee HR Consultants, LLC —Gulf Shores, AL
- Full-time
- Mid-level
- Office
- 3 years
- Disability insurance
- Health insurance
Quick Apply
8d
Equipment Service Manager
Imperial Brady —Birmingham, AL
- Full-time
- Background check
- Clean driving record
- 5 years
- Health insurance
- Dental insurance
Quick Apply
Lead Field Technician
MasTec Advanced Technologies —Pelham, AL
- $24 an hour
- Weekends as needed
- Microsoft Outlook
- Inventory management
- Mid-level
- Paid jury duty
- AD&D insurance
8d
Inside Sales Account Manager
Southeastern Freight Lines —Mobile, AL
- $20 - $27 an hour
- Full-time
- Background check
- Customer service
- Research
- Health savings account
- Health insurance
Recruiter/Account Supervisor Bilingual
Hospitality Staffing Solutions LLC —Birmingham, AL
- $45,000 - $55,000 a year
- Full-time
- 18 years or older
- Spanish
- Computer literacy
- Paid holidays
- Disability insurance
Quick Apply
9d
Parts Manager
SUNSOUTH, LLC —Foley, AL
- $50,000 - $65,000 a year
- Full-time
- Computer literacy
- Merchandising
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
6d
AR Manager
American Promotional Events-TNT Fireworks —Florence, AL
- $65,000 - $75,000 a year
- Overtime
- Background check
- Oracle
- Mid-level
- Health savings account
- Disability insurance
Quick Apply
Assistant Branch Manager - Sales Manager Trainee
Republic Finance, LLC —Auburn, AL
- $45,000 a year
- Full-time
- Pass drug screening
- Office
- Windows
- Paid training
- Paid holidays
Risk & Claims Manager
Chugach Government Solutions —Huntsville, AL
- Overtime
- Microsoft Outlook
- Office
- Finance
8d
Data Manager (MMIS)
Conduent State Healthcare, LLC —Montgomery, AL
- $113,190 - $147,000 a year
- Email
- Microsoft Access
- Computer Science
- 5 years
- Paid holidays
- Disability insurance
DME Manager / Biller
tmc —Mobile, AL
- Full-time
- Customer service
- HIPAA
- Mid-level
- Health insurance
- Dental insurance
Quick Apply

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Manager, Payment Integrity-COB/TPL /Subrogation

Centene -
Alabama

Apply Now

Job Details

Full-time
$87,700 - $157,800 a year
2 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Medical terminology

Full Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:
Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends/schemes

Oversee Coordination of Benefits (COB), Third Party Liability (TPL), and Subrogation recovery activities, including identification of other coverage, validation of recovery opportunities, coordination with internal operational teams, and timely resolution of provider, member, and carrier-related issues
Monitor internal and vendor and platform performance for COB/TPL/Subrogation programs, including savings, inventory, cycle times, quality outcomes, and adherence to recovery policies and regulatory requirements
Monitor business processes and systems to assure integrity and compliance in billing and claims payment
Lead teams of analysts to appropriately investigate all possible fraud, waste and abuse referrals
Develop customized fraud plans to meet contract and federal requirements
Develop educational materials to identify/validate waste activities as requested by the health plan and on an ad-hoc basis
Respond to RFP request and implement new policies per contractual obligation
Attend state/federal meetings as required by specific contracts
Prepare/present the FWA program to state/federal personnel upon request, specifically during readiness reviews, and immediately following the go live or upon state agency personnel changes
Review post-payment cases with appropriate parties to obtain refund
Prepare and distribute monthly and quarterly saving reports
Performs other duties as assigned
Complies with all policies and standards

Education/Experience:
Bachelor’s degree in Business, Healthcare, Criminal Justice, related field, or equivalent experience. 4+ years of medical claim investigation, compliance or fraud and abuse experience. Thorough knowledge of medical terminology required. Experience with Coordination of Benefits (COB), Third Party Liability (TPL), Subrogation, or healthcare recovery operations preferred. Previous experience in managed care environment and as a lead or supervisor of staff, including hiring, training, assigning work and managing performance preferred.

License/Certification: Medical records or coding license preferred.

Pay Range: $87,700.00 - $157,800.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

claims manager jobs in alabama

Manager, Payment Integrity-COB/TPL /Subrogation

Medicaid Claims Operations Manager

Senior Program Manager / Project Manager - Medicaid Claims

PBM Call Center Manager - Remote US

Operations Claims Processing Manager

Sr. Manager, Pricing - Pharmacy Appeals

Credentialing Manager

EHS Manager

General Manager - Transportation

Title Agency Operations Manager

Equipment Service Manager

Lead Field Technician

Inside Sales Account Manager

Recruiter/Account Supervisor Bilingual

Parts Manager

AR Manager

Assistant Branch Manager - Sales Manager Trainee

Risk & Claims Manager

Data Manager (MMIS)

DME Manager / Biller

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