Claims Manager

Company: HaylieRead Interior Design
Location: Dallas
Posted on: May 1, 2025

Job Description:

Lantern is the specialty care platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation's top specialists for surgery, cancer care, infusions and more, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation's largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com.About You:

• You use LOGIC in your decision making and understand that progress is critical to making change. You focus on the execution of your content while balancing a fast-paced environment and you take the time to celebrate both the small & big wins.
• INCLUSION is a core tenant of your personal beliefs. A diverse and inclusive environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with.
• You have the GRIT, drive and ambition to tackle big problems. Big problems require big ideas and a team that supports new ideas.
• You care deeply for your customers and are driven to keep HUMANITY in all decisions. Your customers aren't just the individuals using your product. They are the driving factor in your motivation to make a change.
• Integrity guides you in life. Focusing on the TRUTH vs. giving people the answers they want to hear.
• You thrive in a Team Environment. Collaboration is key in innovation and creating change.These pillars of LIGHT are a reminder to our team that we are making a difference by providing guidance and support in navigating the often complex and confusing landscape of healthcare. We hope that through this LIGHT, individuals can find their way to the best care, resources, and support they need to get back to life.If this sounds like you, we would love to connect to speak further about career opportunities at Lantern.Please apply to our role & someone from our Talent Acquisition Team will reach out to help you navigate our interview process.Claims ManagerThe Revenue Cycle Manager is responsible for overseeing the entire healthcare claims process, ensuring timely and accurate billing, collections, and reimbursement. This role involves managing a team, optimizing revenue cycle processes, and maintaining compliance with healthcare regulations. As the Claims Team Manager, you will be responsible for managing a department of smart, capable, hardworking claims professionals. You will be advising on complex cases and supporting the Director of Revenue Cycle Management with the development and execution of the Claims department roadmap. You'll work hand-in-hand with the Director of RCM and other leaders in the organization to build, develop, and retain top talent. You'll also work closely with external partners, including key provider relationships, and internally with Network Operations and Development teams. A successful candidate will have experience in medical insurance claims administration, a data-driven approach, a customer-focused mindset, and a history of interdepartmental collaboration.Responsibilities:
  • Revenue Cycle Management
    • Oversee the submission, processing, and follow-up of healthcare claims to ensure timely and accurate reimbursement.
    • Ensuring timely and accurate claims processing with external clearing house.
    • Overseeing daily performance indicators of each team.
    • Overseeing claim escalation management and resolution.
    • Generate and analyze reports on key performance indicators (KPIs) related to revenue cycle activities, presenting findings to senior management.
    • People Management
      • Hiring, developing, and retaining talent.
      • Identifying skill gaps for existing team members and facilitating training/retraining.
      • Mentoring and developing first-time supervisors.
      • Managing team schedules to ensure coverage.
      • Model a team-centered culture and reward innovation.
      • Performance Management
        • Reporting on, meeting, and improving upon KPI and SLA targets for the claims lifecycle, including adjudication, payment, auditing, and escalation management.
        • Identifying and resolving problems to ensure provider, client, and member customer satisfaction.
        • Identify and analyze revenue cycle performance trends and provide recommendations to improve performance.
        • Cross-Functional Leadership
          • Support department initiatives and goals.
          • Partner closely with Network teams to ensure successful provider-customer experience.
          • Coordinate cross-functionally with leadership in all business functions to manage dependencies across the organization and mitigate risk.Requirements:
            • Minimum 5 years of experience in healthcare claims administration.
            • Minimum 5 years of experience managing direct and indirect reports.
            • Advanced experience utilizing Microsoft application suite, especially Excel.
            • Ability to work effectively in a team environment.
            • Strong written and verbal communication skills.
            • Strong critical thinking and problem-solving skills.
            • Motivated team player with a positive attitude and ability to work in fast-paced environment.
            • Ability to effectively organize work activities to meet deadlines.Lantern does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.Apply for this job* indicates a required field
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Keywords: HaylieRead Interior Design, Arlington , Claims Manager, Executive , Dallas, Texas