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UHA Work Well logoUHA Work Well

Claims Services Manager

Honolulu, Hawaii, United States · On-site

$91k–$118k/yr

Senior

JOIN UHA’S TEAM We focus on your health and pay 100% for your family's medical insurance and provide 20 days of paid personal time off during your first year! Department: Claims Services FLSA: Full-time, Exempt Sal…

Skills: Claims Processing, People Leadership, Operational Excellence, Analytical Skills, Health Insurance Expertise

UHA Work Well logo

Claims Services Manager

UHA Work Well

Honolulu, Hawaii, United States • On-site

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Senior

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  • $91k–$118k/yr
  • Full-time
  • bachelor degree, professional certificate
  • Medical Insurance, Paid Personal Time Off
  • Posted 4d ago
  • ~40 hrs/week

Responsibilities

Lead the daily operations of the Claim Services and Claim Services Adjustments teams to ensure operational excellence and quality standards. Manage staff development, monitor productivity metrics, and drive continuous process improvements across the department.

Requirements

Requires a bachelor's degree and at least 5 years of supervisory experience in health insurance claims or healthcare operations. Candidates must possess strong knowledge of claims processing, billing, and coding, and must reside on Oʻahu, Hawaiʻi.

Full job description

JOIN UHA’S TEAM

We focus on your health and pay 100% for your family's medical insurance and provide 20 days of paid personal time off during your first year!

Department:  Claims Services

FLSA: Full-time, Exempt

Salary range: $90,954 - $118,240.

 Claims Services Manager 

Position Summary

Join UHA as a Claims Services Manager and lead the daily operations of our Claim Services and Claim Services Adjustments teams. This leadership role is responsible for ensuring operational excellence in claims processing, maintaining quality and turnaround standards, supporting team development, and driving continuous process improvement across the department.

The ideal candidate is a strong people leader with health insurance claims expertise, excellent analytical skills, and a commitment to operational excellence.


Essential Responsibilities

  • Manage the daily operations of the Claim Services and Claim Services Adjustments departments
  • Directly supervise Claim Services Supervisors and Claim Services Adjustments Representatives
  • Monitor claims inventory, productivity, quality, and turnaround metrics to ensure department standards are met
  • Establish and maintain departmental policies, procedures, and performance benchmarks
  • Ensure claims processing accuracy, payment accuracy, and compliance with regulatory and internal standards
  • Oversee complex claims, including special handling, out-of-state network claims, high-cost inpatient claims, and reinsurance claims filing
  • Identify opportunities to improve workflow efficiency, automation, and administrative processes
  • Partner with internal departments, including Financial Services and Information Systems, on process and system enhancements
  • Develop, coach, and evaluate staff through training, performance management, and ongoing development
  • Prepare reports, presentations, and operational updates for leadership


Required Qualifications

  • Bachelor’s degree or equivalent combination of education and relevant work experience required
  • Minimum 5 years of supervisory experience in health insurance claims or related healthcare operations
  • Strong knowledge of claims processing, claims adjustments, billing, coding, and benefits administration
  • Experience managing operational metrics, productivity standards, and service-level expectations
  • Strong leadership, communication, analytical, and problem-solving skills
  • Proficiency in Microsoft Office, including Excel and Word


Preferred Qualifications

  • CPC (Certified Professional Coder) certification preferred
  • Knowledge of healthcare insurance regulations and compliance standards
  • Experience with process improvement and workflow optimization
  • Strong analytical and reporting skills



This position requires residency on Oʻahu, Hawaiʻi 

Competitive compensation & excellent benefits offered

Visit our website at https://uhahealth.com/page/career-opportunities to apply and for details about vacant positions.

 

An Equal Opportunity Employer

Related keywords

Health InsuranceClaims AdjustmentsCPC CertificationCertified Professional CoderReinsurance ClaimsHealthcare OperationsService-Level ExpectationsOperational MetricsCompliance StandardsWorkflow EfficiencyInpatient ClaimsNetwork ClaimsFinancial ServicesInformation Systems

About UHA Work Well

LinkedInVisit site

Helping employers work better

Industry
Insurance
Company size
2-10 employees
Founded
2013
Headquarters
Honolulu, HI
LinkedIn followers
153

Founded in 2013 by UHA Health Insurance, UHA Work Well is open to all businesses interested in concrete solutions to improve the health of their employees and enhance the performance of their organizations, regardless of whether they offer UHA health plans. Our Vision The HH@WA is a partnership of 200+ organizations with the singular purpose of collaboratively learning how to build effective worksite wellness programs and apply methods that lead to sustainable lifestyle change for employees and improved productivity for employers. The Alliance creates the opportunity to: - Learn from subject matter experts about emerging concepts in employee health and wellness - Share best practices in worksite wellness programming - Assist each other in solving problems gained from first-hand experience - Network with other like-minded employers in Hawai‘i Hawai‘i employers know that healthy, fit, active, and happy employees result in a more productive workforce and a healthier Hawai‘i. Employers are constantly striving to improve the health and wellbeing of their employees and their organizations, but, more often than not, they are doing so in isolation. It is with this in mind that UHA Health Insurance formed the Hawai‘i Health at Work Alliance (HH@WA), LLC.

Offices: 700 Bishop Street, Suite 300 Bishop Street Tower, Honolulu, HI 96813, US

Workplace Wellness Solutions
View all jobs at UHA Work Well

About UHA Work Well

LinkedInVisit site

Helping employers work better

Industry
Insurance
Company size
2-10 employees
Founded
2013
Headquarters
Honolulu, HI
LinkedIn followers
153

Founded in 2013 by UHA Health Insurance, UHA Work Well is open to all businesses interested in concrete solutions to improve the health of their employees and enhance the performance of their organizations, regardless of whether they offer UHA health plans. Our Vision The HH@WA is a partnership of 200+ organizations with the singular purpose of collaboratively learning how to build effective worksite wellness programs and apply methods that lead to sustainable lifestyle change for employees and improved productivity for employers. The Alliance creates the opportunity to: - Learn from subject matter experts about emerging concepts in employee health and wellness - Share best practices in worksite wellness programming - Assist each other in solving problems gained from first-hand experience - Network with other like-minded employers in Hawai‘i Hawai‘i employers know that healthy, fit, active, and happy employees result in a more productive workforce and a healthier Hawai‘i. Employers are constantly striving to improve the health and wellbeing of their employees and their organizations, but, more often than not, they are doing so in isolation. It is with this in mind that UHA Health Insurance formed the Hawai‘i Health at Work Alliance (HH@WA), LLC.

Offices: 700 Bishop Street, Suite 300 Bishop Street Tower, Honolulu, HI 96813, US

Workplace Wellness Solutions
View all jobs at UHA Work Well

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