Top 46 Operations claims processing manager Jobs in Montgomery Al

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
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
10d
Claims Administrative Assistant
Alfa Insurance Corporate Careers —Montgomery, AL
- Full-time
- Microsoft Excel
- Office
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
2d
(USA) Asset Protection Operations Coach
Walmart —Wetumpka, AL
- $65,000 - $100,000 a year
- High school
- Bachelor of Science
- Merchandising
- Paid jury duty
- Disability insurance
4d
Warehouse Coordinator
US Foods, Inc. —Montgomery, AL
- $17 - $26 an hour
- Full-time
- Microsoft Excel
- Microsoft Access
- Microsoft Outlook
- Employee stock purchase plan
- Disability insurance
4d
Teller
US Defense Commissary Agency —Maxwell AFB, AL
- $17.82 - $22.68 an hour
- Part-time
- Background check
- 18 years or older
- Pass drug screening
13d
Human Resources Business Partner
Genpak LLC —Hope Hull, AL
- Office
- Bachelor's degree
- Business Administration
Program Director
Acentra Health, LLC —Montgomery, AL
- $145,200 - $181,500 a year
- Full-time
- Computer Science
- HIPAA
- Research
- Health insurance
- Tuition reimbursement
MPPS Policy Deviations Senior Manager
CVS Health —Montgomery, AL
- $67,900 - $182,549 a year
- Full-time
- Nursing
- 5 years
- Bachelor's degree
- Health insurance
- Dental insurance
Program Management Senior
Torch Technologies —Maxwell AFB, AL
- Email
- Background check
- Doctoral degree
- Research
- Health savings account
- Paid holidays
Journeyman Electrician, Facility Services
Walmart —Montgomery, AL
- $33 - $63 an hour
- On call
- Carpentry
- Microsoft Outlook
- High school
- Paid jury duty
- Disability insurance
3d
Technician, Facility Services, HVAC-Refrigeration
Walmart —Montgomery, AL
- $29 - $58 an hour
- On call
- Clean driving record
- Microsoft Outlook
- High school
- Paid jury duty
- Disability insurance
2d
EDW Medicaid Subject Matter Expert/Data Specialist
Vytwo —United States
- Full-time
- Remote
- Writing skills
- DevOps
- SQL
Quick Apply

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Operations Claims Processing Manager
Conduent State Healthcare, LLC —Montgomery, AL
Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, Business Administration, or a related field; or equivalent combination of…
$77,770 - $101,000 a year
Medicaid Claims Operations Manager
General Dynamics Information Technology —Montgomery, AL
May vary based on technical training, certification(s), or degree. As the Claims Operations Manager, you will lead a team responsible for ensuring that Medicaid…
$111,155 - $150,385 a year
10d

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operations claims processing manager jobs near montgomery al

Operations Claims Processing Manager

Conduent State Healthcare, LLC -
Montgomery, AL

Apply Now

Job Details

Full-time
$77,770 - $101,000 a year

Benefits

Paid training
Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
Employee discount
Opportunities for advancement
Retirement plan

Qualifications

Healthcare staff management
Team leadership
Metrics Reporting
Key Performance Indicators
Health insurance knowledge
Managing insurance claims teams
Management reporting
Medicaid regulations
Medicaid
Business operations
Healthcare reimbursement methods
Analytics

Full Job Description

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

The Operations Claims Processing Manager is responsible for leading all Medicaid Claims Processing operations and serves as the primary point of contact for claim-related operational functions. This role provides leadership and oversight for Claims Resolution, Drug Rebate activities, Medical Policy, Financial Transactions, and Data Entry operations.

The ideal candidate is an experienced Medicaid operations leader with a strong background in claims processing, regulatory compliance, performance management, and operational excellence. This individual will drive process improvements, ensure SLA and KPI achievement, and maintain compliance with CMS regulations and Medicaid State Plan requirements.

This position is contingent upon the award of a government contract. Recruiting and interviewing activities may occur prior to contract award; however, employment and start dates are subject to contract award, funding, customer approval requirements, and/or satisfaction of any applicable pre-employment conditions.

Key Responsibilities

Serve as the primary point of contact for all Medicaid Claims Processing operations.
Manage and oversee Claims Resolution, Drug Rebate operations, Medical Policy, Financial Transactions, and Data Entry functions.
Define, implement, and maintain operational policies and procedures.
Identify opportunities for operational improvement and drive process enhancement initiatives.
Lead, coach, and develop claims processing teams and operational staff.
Ensure adherence to established operational processes, policies, and compliance requirements.
Monitor and manage operational tools and systems to support efficient claims processing.
Own and drive achievement of operational Service Level Agreements (SLAs) and Key Performance Indicators (KPIs).
Analyze operational performance metrics and produce reports for leadership and stakeholders.
Serve as the primary point of contact regarding CMS regulations, Medicaid policies, and State Plan requirements.
Partner with internal and external stakeholders to ensure accurate and timely claims processing.
Manage escalated operational issues and implement corrective actions as needed.

Required Qualifications

Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, Business Administration, or a related field; or equivalent combination of education and experience.
Minimum of eight (8) years of experience managing Medicaid claims processing operations or major healthcare payer claims operations.
Demonstrated experience leading claims processing teams and complex operational functions.
Strong knowledge of Medicaid claims processing, reimbursement methodologies, and healthcare operations.
Experience managing operational metrics, SLA performance, and KPI reporting.
Excellent written, verbal, and presentation communication skills.
Strong analytical, organizational, and problem-solving abilities.
Ability to thrive in a fast-paced, high-volume, and high-pressure environment.
Must complete a background check that includes fingerprinting.

Preferred Qualifications

Experience supporting Medicaid programs or government healthcare contracts.
Knowledge of CMS regulations, Medicaid policy, and state healthcare requirements.
Experience with claims adjudication, provider reimbursement, and financial transaction operations.
Proven track record of implementing operational improvements that increase efficiency and quality.
Experience presenting operational results to executive leadership and government agency stakeholders.

Flexible Working

At Conduent, we want you to be yourself. We recognize that everyone is different and that how people want to work and deliver at their best is different for everyone too.

In this role, you can expect the following working conditions:

Onsite work: Work in our local office, receiving personal coaching and leadership so that you can provide the best support to our clients and help you grow in your career.

Working For You

Perks and rewards designed for you:

Health and Welfare Benefits: Our health and welfare benefits can be tailored to fit you and your family's needs and start on the first day of employment.
Retirement Savings: We will support you as you save for your future.
Employee Discounts: We offer you access to a vast selection of global, national, and local discounts on merchandise, services, travel, and more.
Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
Paid Training: Earn while you learn and continue to grow with access to award-winning learning platforms throughout your Conduent career.
Paid time off: We provide attractive paid time off packages designed for you to enjoy your life away from work.
Great Work Environment: We are proud of our award-winning culture and the recognition we’ve received for our diversity efforts.

Join Us

At Conduent, we are one team, one mission. We understand that our success is directly related to the success of our associates.

We strive to create a culture where you can:

Bring your authentic self to work.
Grow and thrive, both personally and professionally.
Make a difference with our clients, in our communities, and with the millions of people we support.

Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary for this role is $77,770-101,000.

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form. Complete the form and then email it as an attachment to [email protected]. You may also click here to access Conduent's ADAAA Accommodation Policy.

Apply Now

Refine Your Search

operations claims processing manager jobs in montgomery al

Operations Claims Processing Manager

Medicaid Claims Operations Manager

Claims Administrative Assistant

(USA) Asset Protection Operations Coach

Warehouse Coordinator

Teller

Human Resources Business Partner

Program Director

MPPS Policy Deviations Senior Manager

Program Management Senior

Journeyman Electrician, Facility Services

Technician, Facility Services, HVAC-Refrigeration

EDW Medicaid Subject Matter Expert/Data Specialist

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