Claims Manager

Role Description The Claims Manager role is a part-time, remote position responsible for overseeing the end-to-end claims process for healthcare clients. On a day-to-day basis, the Claims Manager reviews, validates, and processes insurance claims to ensure accuracy, compliance, and timely submission. This role manages claim workflows, monitors status updates, identifies patterns in denials, and coordinates resolution efforts to secure appropriate reimbursement. The Claims Manager collaborates with internal billing teams and client practices to clarify documentation, interpret payer policies, and implement process improvements that reduce errors and improve claim outcomes. The position also involves maintaining detailed records, preparing claims-related reports, and contributing to best practices for claims management within Pulse Peak Health.QualificationsStrong claims handling and claims management skills, with experience managing healthcare or medical billing claims across multiple payers.Solid understanding of insurance and insurance claims processes, including payer rules, coverage policies, and regulatory requirements.Excellent analytical skills for identifying trends, root causes of denials, and opportunities to improve claim accuracy and reimbursement.Experience with medical billing or revenue cycle management systems, and proficiency in using practice management or EHR software.Attention to detail, strong organizational skills, and the ability to manage multiple claims and priorities in a remote environment.Clear written and verbal communication skills for collaborating with internal teams and client practices in a professional manner.Prior experience in healthcare RCM, insurance, or a related field is preferred; relevant certifications or training in medical billing or coding are a plus.Ability to work independently, uphold confidentiality, and follow non-discriminatory, compliant practices in all claims-related activities.