Quality Manager, Claims Processing - Tampa

Imagenet, LLC is seeking an experienced Quality Manager, Claims Processing to join our team. In this role, you will be responsible for overseeing the performance and quality of our claims processing department.

 Responsibilities:

Develop and implement quality assurance policies, procedures, and standards for claims processing.

Monitor claims processing metrics such as productivity, accuracy, turnaround times, and customer satisfaction

Identify areas for improvement in claims processing and develop solutions

Conduct audits on a sample of processed claims to ensure adherence to regulations, guidelines, and quality standards

Analyze performance data, identify trends and root causes of defects, and suggest process improvements

Coach and mentor claims processing staff on performance, compliance, and career development

Create and manage quality assurance training programs for claims staff

Track quality standards and report on quality goals and progress to senior management

Requirements:

Previous claims processing quality management or related field preferred

5+ years of experience in claims processing, including 3+ years in a quality assurance role

Expert knowledge of claims processing procedures, quality standards, and regulatory requirements

Strong analytical and problem-solving skills

Ability to interpret data and generate detailed reports (daily/weekly/monthly) in graphs & presentations

Experience developing and conducting quality audits

Leadership skills with the ability to influence outcomes and drive change

Excellent communication and presentation abilities

This is an opportunity to oversee quality for a growing claims processing provider . If you have the required claims processing and quality assurance experience, please apply with your resume.