Claims Manager

Delta Health Systems

. Supervise assigned staff, including training, planning, directing work, appraising performance, rewarding, and addressing complaints .

Posted 10/9/2026full-timeFresno • California • United StatesJuniorMid-Level💰 $72,384 - $78,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong leadership and management skills in supervising staff, conducting performance evaluations, and ensuring compliance with health insurance claims regulations. Proficient in developing interdepartmental relationships and managing operational processes within budgetary constraints.

Highest-signal resume keywords

Management ExperienceClaims ExperienceLeadership AbilitiesCommunication SkillsUnderstanding of Health Insurance Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingPerformance EvaluationBudget ManagementAutomated Claims SystemsSpreadsheet ProficiencyWord Processing ProficiencyRegulatory ComplianceCorrective Action PlanningInterdepartmental CollaborationCustomer Relationship Management

Soft Skills

Interpersonal SkillsMentoringConflict ResolutionTeam BuildingCustomer Service

Industry Keywords

Self-Funded Payer Claims PoliciesFederal RegulationsState RegulationsTPLCOBCoding MethodologiesReimbursement MethodologiesCollective Bargaining AgreementsClient ServicesPerformance Improvement Plans

About the role

Key responsibilities & impact

Supervise assigned staff, including training, planning, directing work, appraising performance, rewarding, and addressing complaints
Mentor, educate, provide corrective action and performance improvement plans, and discipline staff when necessary
Participate in interviews for new staff
Conduct monthly 1:1, quarterly, and annual performance reviews
Respond to staff and internal and external customer inquiries and resolve issues
Evaluate department performance and take corrective action when necessary
Ensure inventory, assigned queues, and processes are handled within department guidelines
Review department reports for accuracy, thoroughness, and timeliness
Interpret plan provisions and recommend system administrative improvements
Develop effective interdepartmental and customer relationships
Manage within the established unit budget
Collaborate with Information Services on system enhancements and claims-flow improvements
Assist Client Services with client requests and deadlines
Participate in new business implementations
Enforce department policies, procedures, and Collective Bargaining Agreements
Participate in department meetings and continual training
Represent the company at existing and prospective customer meetings
Uphold and exemplify company values
Occasionally travel to client locations
Perform other duties as assigned

Requirements

What you’ll need

Two to four years of management and claims experience
Computer literacy with proficiency in spreadsheet and word processing applications
Excellent written and verbal communication skills
Excellent leadership abilities and interpersonal skills
Ability to establish confidence, rapport, and cooperative relationships with clients, providers, and co-workers
Understanding of self-funded payer claims policies
Understanding of Federal, State, and other regulations pertaining to health insurance claims payment, including TPL, COB, and coding and reimbursement methodologies
Experience with automated claims systems
Ability to maintain sound production operations
Must occasionally travel to client locations