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Full-time
bachelor degree, postgraduate degree, professional certificate
Posted 2d ago
~40 hrs/week
Responsibilities
The Claims Finance Manager acts as the primary link between Claims Operations and Corporate Finance to ensure payment accuracy and financial accountability. The role involves analyzing claim costs, managing funding reconciliations, and providing financial insights to support strategic business objectives.
Requirements
Requires a bachelor's degree in Finance, Accounting, or a related field and at least 5 years of experience in finance or healthcare claims operations. Candidates must possess strong analytical skills and a deep understanding of reimbursement methodologies and payment integrity.
Full job description
Careington International is looking to add a Claims Finance Manager to our TEAM. This position will be worked onsite at 7400 Gaylord Pkwy in Frisco, TX.
The Claims Finance Manager serves as the critical link between Claims Operations and Corporate Finance, ensuring financial accountability, payment accuracy, and operational efficiency throughout the claims adjudication lifecycle. This role translates claims activity into financial insights by analyzing claim costs, reimbursement trends, adjudication outcomes, reserve impacts, and operational performance.
The Claims Finance Manager partners with Accounting & Finance, Claims, Configuration, Revenue Operations, Product, and Executive Leadership to evaluate the financial impact of claims decisions, identify opportunities to reduce payment leakage, improve adjudication accuracy, and support strategic business objectives. This position plays a key role in balancing financial stewardship, customer obligations, and operational excellence.
EXPECTED WORK AND PERFORMANCE:
Claims Finance & Financial Oversight
Serve as the primary liaison between Claims Operations and Accounting & Finance, bridging claims adjudication activities with corporate financial objectives
Analyze claims payment activity, funding, payment activity, adjudication outcomes, and reimbursement trends to ensure financial accuracy and integrity
Monitor claim costs, payment variances, financial leakage, recoveries, and adjustments
Evaluate the financial impact of claim processing decisions, benefit configurations, and reimbursement methodologies
Support the development of financial controls that ensure accurate and compliant claim payments
Manage the claims operational financial tasks such as:
Client Request for Funds/Credits
Provider Claim Payment Cycle Processing
Provider Recoupments
Own the reconciliation of claims funding, payment disbursements, credits, recoupments, refunds, and related general ledger activity
Research and resolve variances, aged reconciling items, unapplied funds, outstanding payments, and funding shortfalls in partnership with Claims and Accounting & Finance
Claims Adjudication Analysis
Review adjudicated claims to identify trends, anomalies, and opportunities for process improvement
Partner with Claims and Configuration teams to investigate payment discrepancies and adjudication errors
Analyze denial, appeal, adjustment, and rework trends to identify operational and financial risks
Monitor first-pass adjudication rates, auto-adjudication performance, and payment accuracy metrics
Provide recommendations to improve claims accuracy while reducing administrative costs
Financial Planning & Reporting
Develop financial reports, dashboards, and analyses related to claims operations
Support budgeting, forecasting, and financial planning activities related to claims volume, costs, and operational expenses
Prepare executive-level reporting on claims financial performance, trends, risks, and opportunities
Translate operational claims data into meaningful financial insights for leadership decision-making
Business Partnership & Strategy
Collaborate with Claims Leadership, Product, Technology, Client Services, and Finance teams to support organizational goals
Assess the financial impact of system enhancements, configuration changes, new client implementations, and process improvements
Support strategic initiatives focused on reducing claim costs, improving adjudication efficiency, and increasing profitability
Provide financial guidance during audits, client reviews, and operational assessments
Risk Management & Compliance
Ensure claims-related financial processes comply with contractual, regulatory, and organizational requirements
Support internal and external audits related to claims payments and financial controls
Identify financial risks associated with claims processing and recommend mitigation strategies
Maintain oversight of payment integrity and recovery initiatives
People Management & Development
Effectively manage, coach and development members of the team.
QUALIFICATIONS:
Required
Bachelor's degree in Finance, Accounting, Business Administration, Healthcare Administration, or related field
5+ years of experience in finance, claims operations, healthcare administration, insurance, or revenue cycle management
Strong understanding of claims adjudication, reimbursement methodologies, and payment integrity principles
Experience performing financial analysis and reporting in a claims-driven environment
Advanced Excel and data analysis skills
Preferred
Experience within healthcare claims administration, dental benefits, vision benefits, TPAs, or insurance organizations.
Working knowledge of financial procedures like escheatment and 1099 processing.
MBA, CPA, CMA, or similar professional certification.
Experience with claims adjudication platforms, payment integrity tools, and business intelligence reporting systems.
SKILLS:
Strong understanding of both claims operations and financial management principles.
Ability to connect operational claim outcomes with financial performance.
Expertise in claims payment analysis, reimbursement methodologies, and cost containment strategies.
Strong analytical and problem-solving skills.
Ability to communicate complex financial concepts to operational leaders.
Experience leading cross-functional initiatives and process improvement efforts.
Excellent presentation, reporting, and stakeholder management skills.
Your solution for dental discount plans and network access, product aggregation, TPA services and more.
Industry
Wellness and Fitness Services
Company size
201-500 employees
Founded
1979
Headquarters
Frisco, Texas
LinkedIn followers
14,993
Careington International Corporation is a leading provider of discount programs for health, wellness and lifestyle services. The diversity and expertise of Careington's people create an extraordinary suite of products and services designed to provide unparalleled network provider access, significant savings and unsurpassed value to any client or customer.
Offices: 7400 Gaylord Parkway, Frisco, Texas 75034, US
Discount health careDental networkHealth benefitsand Value added benefitsHealth CareWellnessDentalReputation
How much do Finance & Accounting jobs in Frisco, TX pay?
Based on 166 listings with disclosed salaries, most finance & accounting jobs in Frisco, TX pay between $65k–$186k per year. Individual offers vary with seniority, company size, and specialization.
How many Finance & Accounting jobs are open in Frisco, TX right now?
There are currently 256 open finance & accounting positions in Frisco, TX listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Finance & Accounting roles in Frisco, TX?
Companies currently hiring include TIAA, Baker Tilly US, Thomson Reuters, IQ-EQ, Keurig Dr Pepper Inc., among others. Browse the listings above to see every active employer.
Are there remote or hybrid Finance & Accounting jobs in Frisco, TX?
Yes — 128 of the 256 open finance & accounting positions offer remote or hybrid work (29 remote, 99 hybrid).
How do I apply for Finance & Accounting jobs in Frisco, TX?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.