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Claims Processing Manager Jobs in Baton Rouge, LA

Squaremouth

Claims Advocate

Baton Rouge, LA · On-site

Commercial Claims Advocate HUB International Limited ("HUB") is one of the largest global insurance ... management of Workers Compensation process * Keep an updated record with the required claim ...

HUB

Claims Advocate

Baton Rouge, LA · On-site

The Commercial Claims Advocate is responsible for claim consulting and management service to ... management of Workers Compensation process * Keep an updated record with the required claim ...

Unum UK

Associate VB Claims Specialist

Baton Rouge, LA · Remote

$25/hr

Incumbent must demonstrate the ability to effectively manage an assigned caseload, exercise ... Ensure a timely and well communicated transfer process when transitioning integrated claims across ...

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Claims Processing Manager information

See Baton Rouge, LA salary details

$33.6K

$84.4K

$133.5K

How much do claims processing manager jobs pay per year?

As of Aug 6, 2026, the average yearly pay for claims processing manager in Baton Rouge, LA is $84,368.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,300.00 and $100,800.00 per year, depending on experience, location, and employer.

What are the primary challenges faced by a claims processing manager, and how can they be addressed?

Claims Processing Managers often navigate challenges such as ensuring timely and accurate claim adjudication, managing a team with varying workloads, and staying up to date with regulatory changes. Balancing efficiency with compliance requires strong organizational skills and effective communication. Successful managers foster a collaborative environment, implement regular training, and leverage technology to streamline processes, all while maintaining high standards of customer service and data integrity.

What does a claims processing manager do?

A Claims Processing Manager oversees the team responsible for reviewing, evaluating, and processing insurance claims. Their duties include ensuring claims are handled efficiently and accurately, developing procedures to improve workflow, and maintaining compliance with industry regulations. They also resolve complex or escalated claims issues, provide staff training, and report on performance metrics. The role requires strong leadership, analytical skills, and attention to detail to ensure a fair and timely claims process.

What are the key skills and qualifications needed to thrive as a claims processing manager?

To thrive as a Claims Processing Manager, you need expertise in insurance claims procedures, analytical skills, and a solid understanding of regulatory compliance, often supported by a bachelor's degree and relevant industry experience. Familiarity with claims management software, workflow automation tools, and data analysis systems is typically required. Strong leadership, attention to detail, and effective communication are crucial soft skills that set top performers apart in this role. These abilities ensure accurate and efficient claims processing, regulatory adherence, and effective team management, all of which are vital for organizational success.
Claims Processing Manager jobs near you

Claims Specialist II (Medical Claims / Coordination of Benefits)

Strategic Staffing Solutions

Baton Rouge, LA • Remote

$19/hr

Other

Medical

Posted 5 days ago

Job description

Job Description Claims Specialist II (Medical Claims / Coordination of Benefits) Location: Remote (Louisiana Preferred) Contract Length: 5 Months Pay Rate: Up to $19/hour (W2) Industry: Health Insurance / Medical Claims Position Summary We are seeking an experienced Claims Specialist II with medical claims processing experience to support a high-volume health insurance claims operation. This position is responsible for processing and adjusting medical claims, researching claim issues, determining Coordination of Benefits (COB), recovering overpayments, and ensuring claims are processed accurately while maintaining compliance with HIPAA and company policies. Louisiana candidates are preferred.

This is a remote opportunity. Required Qualifications High School Diploma or equivalent Minimum 2 years of medical claims processing experience Claims processing experience is required Coordination of Benefits (COB) experience strongly preferred Experience determining primary vs. secondary insurance coverage Knowledge of medical claims adjudication and claims edits Strong analytical, problem-solving, and investigative skills Excellent verbal and written communication skills Working knowledge of Microsoft Office and claims processing systems Ability to prioritize multiple workstreams in a fast-paced environment Preferred Experience Hands-on Coordination of Benefits (COB) processing Medicare coordination and primacy determination Provider reimbursement and overpayment recovery Health insurance or managed care environment Key Responsibilities Process medical claims, claims edits, and claims adjustments accurately.

Research and determine the correct Coordination of Benefits (COB) for members with multiple insurance plans. Identify primary and secondary coverage using subscriber status, plan type, Medicare coordination, and effective dates. Review and update claims to ensure proper payment and reimbursement.

Investigate and resolve complex claims issues and discrepancies. Process refunds and recover overpayments from providers or members. Communicate with providers, members, Medicare, and other insurance carriers regarding claim status and coverage.

Maintain accurate claims records while ensuring compliance with HIPAA and regulatory requirements. Review quality audits and complete corrections within departmental guidelines. Support special projects, training initiatives, and departmental process improvements.

Preferred Knowledge Medical claims adjudication Coordination of Benefits (COB) Medicare primacy rules Provider reimbursement Claims adjustments and overpayment recovery HIPAA compliance Medical terminology Health insurance operations Ideal Background Candidates with experience in organizations such as: Blue Cross Blue Shield UnitedHealthcare / Optum Humana Elevance Health (Anthem) Aetna / CVS Health Cigna Centene Molina Healthcare Kaiser Permanente Highmark GuideWell / Florida Blue CareFirst HealthPartners AmeriHealth This opportunity is ideal for candidates with strong medical claims processing and Coordination of Benefits (COB) experience who thrive in a detail-oriented, production-focused healthcare environment.

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