Job Details

Claims Manager

  2025-07-31     prominence health     Reno,NV  
Description:

Join to apply for the Claims Manager role at Prominence Health.

Responsibilities

  • Manage claims for Commercial, ASO, and Medicare products.
  • Provide training to staff in accordance with contracts, rules, regulations, policies, and procedures.
  • Oversee and coordinate interaction with various health plan departments.
  • Ensure all claims are paid timely and resolve questions regarding claim payments and benefits.

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration. Founded in 1993, it was acquired by UHS in 2014 and serves across Medicare, Medicare Advantage, ACOs, and commercial partnerships. Committed to transforming healthcare delivery by improving outcomes, controlling costs, and enhancing patient experience.

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Qualifications

  • Bachelor's Degree or equivalent experience
  • Minimum 5 years experience in a health plan environment, including Medicare/Medicaid claims processing
  • At least 2 years supervisory experience
  • Proficiency in advanced computer systems and Microsoft Office
  • Excellent communication, organizational, and interpersonal skills
  • Ability to maintain confidentiality and work independently

Benefits

  • Loan Forgiveness Program
  • Challenging and rewarding work environment
  • Competitive pay and generous PTO
  • Medical, Dental, Vision, and Prescription Plans
  • 401(K) with company match
  • Career development opportunities

Employment Details

  • Type: Full-time
  • Function: Finance and Sales
  • Industries: Hospitals, Healthcare, Mental Health

This job is active and accepting applications.

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