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Hmo Claim Manager Jobs (NOW HIRING)

Big Oak Rehabilitation and Healthcare

Medical Biller

Elmer, NJ · On-site

$16.25 - $20.75/hr

This position works with Medicare, Medicaid, Managed Care/HMO plans, commercial insurance carriers ... Monitor claim status and resolve denials, rejections, and unpaid claims. * Appeal denied claims and ...

Managed Staffing

Claims Examiner

Whittier, CA · On-site

$30 - $32/hr

Handle claims received from hospitals and affiliated medical groups for HMO patients. * Apply ... Interpret contract reimbursement terms and apply them to claim adjudication. * Identify non ...

The Wisdom Teeth Guys

Revenue Cycle Manager

Houston, TX · On-site +1

$120K - $145K/yr

End-to-end revenue cycle: verification, coding support, claim submission, payment posting, AR and ... PPO, HMO, and Medicaid verification and claims; coding; denials and appeals. * Process builder: you ...

Oso Home Care

Reimbursement Specialist

Irvine, CA · On-site

$25 - $31/hr

This position manages the billing process from claim creation through reimbursement by ensuring ... Experience billing Medicare, Medi-Cal, Managed Medi-Cal, Medicare Advantage, PPO, HMO, and ...

Oso Home Care

Reimbursement Specialist

Irvine, CA · On-site

$25 - $31/hr

This position manages the billing process from claim creation through reimbursement by ensuring ... Experience billing Medicare, Medi-Cal, Managed Medi-Cal, Medicare Advantage, PPO, HMO, and ...

The Wisdom Teeth Guys

Revenue Cycle Manager

Houston, TX · On-site

End-to-end revenue cycle: verification, coding support, claim submission, payment posting, AR and ... PPO, HMO, and Medicaid verification and claims; coding; denials and appeals. * Process builder: you ...

Wisdom Teeth Guys

Revenue Cycle Manager

Houston, TX · On-site +1

$120K - $145K/yr

End-to-end revenue cycle: verification, coding support, claim submission, payment posting, AR and ... PPO, HMO, and Medicaid verification and claims; coding; denials and appeals. * Process builder: you ...

Oso Home Care

Major Medical Collector HYBRID

Irvine, CA · On-site

$21 - $33.15/hr

Managed Medi-Cal * Commercial PPO and HMO plans * IPA Medical Groups * Workers' Compensation ... Investigate claim denials to determine root causes. * Prepare first-level, second-level, and ...

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Showing results 21-40

All JobsFinance And Insurance JobsInsurance JobsInsurance Claims Specialist JobsHmo Claim Manager Jobs

Hmo Claim Manager information

See salary details

$35K

$87.9K

$139K

How much do hmo claim manager jobs pay per year?

As of Sep 14, 2026, the average yearly pay for hmo claim manager in the United States is $87,861.00, according to ZipRecruiter salary data. Most workers in this role earn between $68,000.00 and $105,000.00 per year, depending on experience, location, and employer.

What are popular job titles related to Hmo Claim Manager jobs?

For Hmo Claim Manager jobs, the most frequently searched job titles are:

Infographic showing various Hmo Claim Manager job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $87,861 per year, or $42.2 per hour.

Manager, Eligibility and Benefits

Walnut Creek, CA • On-site

Integrated Pain Management Medical Group, Inc.
See more jobs at Integrated Pain Management Medical Group, Inc.external

$87K - $104K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 19 days ago

Job description

The Manager of Eligibility & Benefits directs the daily operations of the insurance verification, financial clearance, and point-of-service collection teams across all clinical specialties. This role is responsible for standardizing electronic eligibility workflows, ensuring accurate coverage of data entry, and eliminating front-end office claim denials. Additionally, the manager drives revenue retention by implementing strict processes that ensure patient co-pays, deductibles, and outstanding prior balances are accurately calculated and successfully collected prior to or on the date of service.
*This is a remote role
What you will do:

  • Supervise, train, and schedule eligibility verification and insurance specialist teams.
  • Ensure estimated patient financial responsibility is identified prior to service whenever information is available
  • Support accurate communication of expected copays, deductibles, coinsurance, and other patient responsibility
  • Establish escalation procedures for high-dollar patient responsibility, coverage exclusions, or benefit limitations requiring additional patient communication
  • Multi-Specialty Workflow Management: Oversee eligibility verification workflows for diverse clinical lines, ranging from specialty care to high-cost surgical and diagnostic specialties
  • Denial Prevention: Partner with the billing and coding teams to analyze backend rejection data and implement root-cause fixes for eligibility-related claim denials
  • Payer Portal Governance: Serve as the primary administrator for major commercial payer portals (E.g., Availity, Optum, United Healthcare, Anthem) to resolve complex coverage issues
  • Assumes other responsibilities as appropriate to the position and organizational needs
Qualifications:
  • Minimum 5 years of experience in healthcare revenue cycle, patient access, eligibility, benefits, or related experience
  • Experience working with Medicare and commercial insurance plans
  • Strong understanding of deductibles, copays, coinsurance, out-of-pocket maximums, referrals, prior authorization requirement, coordination of benefits
  • Process Improvement Expertise: Proven track record of managing and improving front-end or point-of-service collection rates in a healthcare setting
  • Leadership: At least 2-3 years of direct supervisory or management experience leading healthcare administrative teams
  • Payer Knowledge: Expert-level understanding of commercial insurance products, including HMO, PPO, and EPO.
  • System Proficiency: Advanced, hands-on experience utilizing enterprise-level EHR platforms (e.g. Epic, IMS, e-Clinical Works) and integrated payment collection software
  • Advanced proficiency in Microsoft Excel (e.g., formulas, pivot tables) and solid skills in other Microsoft Office applications
Compensation Range:
$87,360 - $104,000 annually
All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations.
Why You'll Love Working Here:
  • Amazing work/life balance
  • Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
  • 401(K) Plan with Employer Matching
  • License & Tuition Reimbursements
  • Paid Time Off
  • Holiday Pay & Floating Holiday
  • Employee Perks and Discount Programs
  • Supportive environment to help you grow and succeed

Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of experienced, committed healthcare providers that treat pain. Our team of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain. Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC.
Boomerang Healthcare strives to be a diverse workforce that reflects, at all job levels, the patients we serve. We are an equal opportunity employer. Boomerang Healthcare is committed to compliance with the American Disabilities Act. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us.
Monday-Friday, 8am-5pm
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