tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.
Claims Manager
Location
United States
Posted
6 days ago
Salary
0
Seniority
Lead
No structured requirement data.
Job Description
Claims Manager
Tango Care
Role Description tango is currently looking for a Claims Manager to join our growing team! The Claims Manager provides tactical, technical leadership for claims operations with a focus on issue resolution, process improvement, auditing, and cross-functional support. This role is specialized in technical troubleshooting, claims reconciliation, batch processing, and collaboration with internal partners to ensure the smooth operation of claims workflows. Office Location: 2415 E Camelback Road, Suite 700, Phoenix, AZ 85016 Remote Responsibilities and Duties - Serve as technical lead for problem-solving claims issues; troubleshoot and resolve issues during operational disruptions. - Oversee batch assignments, batch-closure operations, adjudication runs and claims reconciliation processes. - Execute audit and universe review protocols; ensure data integrity and accuracy across all claims transactions. - Oversee the 277CA process. - Oversee performance of systemic tools (Symkey, AMP$, EDIWORKS, SDS or other applicable tools) to ensure transparency, capability alignment, and long-term sustainability, enabling the team to operate efficiently and effectively. - Ensure SFTP process reliability for claims file transfers; monitor all inbound and outbound jobs and alert to transmission failures. - Manage and remediate clearinghouse rejections; coordinate correction cycles with vendors and internal teams. - Collaborate with QA and team members to identify, test, and implement new business rules to improve adjudication rates and minimize claim errors. - Partner with Provider Contracting, Networks, and Accounting teams to resolve fee schedule, network setup, and payment processing issues. - Collaborate with Eligibility and Authorization teams to resolve member-related issues impacting claims processing. - Maintain comprehensive documentation of all processes, issue resolutions, and system updates. - Recommend and implement process improvements based on operational analysis and performance metrics. Qualifications - Bachelor's degree or equivalent technical experience. - 5+ years in healthcare claims operations, with expertise in workflow optimization and technical troubleshooting. - Strong knowledge of claims adjudication, batch processing, EDI/clearinghouse operations, and accounting reconciliation. - Advanced understanding of SFTP/file transfer protocols and claims system architecture. - Proficiency with claims platforms, data analysis, and SQL or similar query tools preferred. - Excellent analytical, organizational, and cross-functional communication skills. - Ability to manage multiple complex issues and prioritize effectively in a fast-paced environment. Requirements - Technical problem-solver with strong analytical and troubleshooting capabilities. - Proactive and detail-oriented with commitment to accuracy and process integrity. - Strong collaboration skills with ability to partner across departments and teams. - Initiative-driven with focus on continuous improvement and operational efficiency. - Reliable and accountable with strong work ethic and deadline commitment. - Self-motivated learner with ability to stay current on system and regulatory changes. - Composed and professional under pressure with strong decision-making abilities. Company Description tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.
Related Guides
Related Categories
Related Job Pages
More Manager Jobs
Role Description The Polymer & Profiles Regional Sales Manager is responsible for driving sales growth and maximizing margin within the Polymer & Profiles (formerly lighting) product segment across an assigned geographic region. This role focuses on servicing and expanding business at OEM customers and distribution channels through technical product knowledge, strategic account management, and alignment with Plaskolite’s customer-centric approach. The position does not include direct reports but requires strong collaboration with cross-functional teams including Marketing, Product Management, Manufacturing, and Supply Chain to meet customer expectations and Plaskolite’s strategic objectives. This position requires attention to detail, the ability to work in a fast-paced manufacturing environment, and a strong commitment to safety, teamwork, and quality—reflecting Plaskolite’s core values of Integrity and Improvement. Qualifications - Bachelor’s degree in Business Administration, Marketing, Sales, Management, or a related field preferred - Equivalent combination of education and relevant work experience may be considered - MBA or advanced business degree a plus, but not required - 5–10 years of progressive sales experience, preferably in B2B, industrial, manufacturing - Proven track record of meeting or exceeding revenue and margin targets - Experience developing and executing regional sales strategies - Strong background in key account management, contract negotiation and pricing strategies, forecasting, budgeting, and pipeline management - Experience working with CRM systems (Salesforce or similar) - Ability to analyze sales data and market trends to drive growth - Experience collaborating cross-functionally with operations, marketing, and customer service - Willingness and ability to travel within the assigned region (often 30–50%) Requirements - Manage and grow sales for the Polymer & Profiles product line, which includes acrylic polymer, custom extruded profiles, lighting based sheet & films, along with specialty products like Jungbecker technology, within an assigned region. - Develop and execute account-level strategies that align with Plaskolite’s revenue, margin, and growth goals. - Maintain strong relationships with existing OEMs and select distribution partners, while identifying and cultivating new opportunities across targeted market segments. - Partner with Product Management and Marketing to translate customer feedback and market insights into actionable strategies for product development and promotion. - Provide technical support and product training to customers to ensure correct application and differentiation of Polymer & Profiles offerings. - Collaborate and coordinate with engineering, operations, R&D teams as needed for any additional technical assistance, including processing guidance regarding Acrylic Polymers. - Coordinate field/site visits with 3rd party molders/extruders as seen fit. - Act as a liaison between the customer and internal teams including Operations, Customer Service, and Supply Chain to ensure seamless fulfillment, service, and communication. - Monitor and report on regional sales performance, forecasts, pricing trends, and competitive activity to inform strategic decision-making. - Promote the advantages of Plaskolite’s bundled product offering and integrated value proposition across customer accounts. - Collaborate cross-functionally to ensure consistency in service and execution, aligned with the ‘One Plaskolite’ culture and core values. - Participate in industry events, trade shows, and customer meetings to reinforce brand visibility and strengthen market position. - Assess customer/targets needs and requests to identify the correct product solution, and work with internal support teams to develop relevant quotations for such products and/or services. - Responsible for daily/weekly documentation of customer visits/meetings, trade show visits/events, utilizing Salesforce CRM system. - Daily/Weekly tracking and entry of all commercial opportunities within Polymer and Profiles utilizing Salesforce CRM system. - Responsible for negotiating/executing supply contracts and in coordination with support from the General Manager. - All other duties as assigned. Benefits - Sign-On Bonus - Health Insurance - 401(k) and Employer Contribution - Paid Time Off - Paid Holidays - Dental Insurance - Vision Insurance - Life Insurance - Employee Discount Program - Tuition Reimbursement - Voluntary Life Insurance
Broker Manager
Devoted HealthOur mission: to dramatically improve the health & well-being of older Americans by caring for everyone like family
• Must be located somewhere between the Philadelphia and Harrisburg areas • As the Broker Manager you will be responsible for the success, engagement and production of our independent agents. • You will work closely with Operations and field sales management to ensure the brokers have clear line of sight to Devoted's mission and the plan for growth. • Executing the plan created by the team for the market's brokers • Analyzes reports and providing a plan of action for increased production • Providing real time feedback from the field brokers. • Training for brokers both classroom and field • Influence brokers to sell more by positioning our product and promoting our brand • Responsible for a territory, manage contacts • Execute on market / region sales goals and objectives (sales events, training, etc) • Meet or exceed sales objectives through broker channel • Meet with brokers and agencies to build relationships and promote our brand • Responsible for reporting their daily activities to ensure alignment with creating incremental sales consistent with market goals • Adheres to and maintains current understanding of compliance requirements and organizational policies & procedures • Coordinates effectively with local sales team
District Manager
Circle KOur mission is to make our customers' lives a little easier every day | Growing Together
• The successful candidate will be responsible for overseeing the efficient and profitable operation of approximately 10-15 stores. • Act as a liaison between stores and Support Office working in partnership with Market Managers, Corporate Store Managers, and Business Partners. • Support a group of store operators on all aspects of store operations including controls, promotional activity, community involvements, store inspections and overall performance. • Prioritize customer service, engagement and resolve escalated customer concerns. • Conduct market meetings, deliver training initiatives and inform store operators of directives. • Supervise store operations, housekeeping, stock levels, and enforce corporate policies and procedures. • Monitor sales, competitive pricing, sales incentives and promotional programs. • Execute all security, mystery shop, as well as health and safety programs. • Comply with all company standards and adhere to government legislation. • Actively participate in recruitment, selection and development of store operators and corporate managers. • Minimize loss prevention by enforcing inventory control, levels, turns and theft investigation. • Responsible for P&L, top line sales achievement and contract execution. • Communicate all required information and reports through proper channels. • Contact and control outside services, as required. Follow merchandising programs, store sets, and participate in store renovations. Any special projects, as directed.
• Develops profitable new business account relationships and increases profitability from existing accounts • Identifies business opportunities based on knowledge of clients, markets, products, and services • Makes sales presentations to existing and prospective clients informing them of benefits of using the organization's products and services • Implements and maintains an effective referral network and call program to promote sales


