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Tpa Operations Manager Jobs in Texas (NOW HIRING)

BC&L INC

TPA Services Manager

Austin, TX

The TPA Services Manager is responsible for the daily supervision and coordination of core TPA ... This role ensures that operational workflows run efficiently, service standards are met, and staff ...

Louisville Ballet

Managing Director

Austin, TX · On-site

The position is responsible for implementing the Executive & Artistic Director's strategic vision by leading daily operations, providing financial management, and guiding the work of TPA ...

Hippo Insurance

Director, TPA Claims

Austin, TX · On-site

... Operations * Own quality assurance, file audits, and reserving accuracy for the TPA claims book, including full accountability for litigation strategy, defense counsel management, and litigation ...

Hippo Insurance

Director, TPA Claims

Austin, TX · On-site

... Operations * Own quality assurance, file audits, and reserving accuracy for the TPA claims book, including full accountability for litigation strategy, defense counsel management, and litigation ...

AIG

Complex Claims Director - TPA Oversight

Dallas, TX · On-site

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Complex Claims ... It is an exciting time to join us - across our operations, we are thinking in new and innovative ...

Zurich NA

TPA Service Specialist TravelGuard

Addison, TX · On-site

$95K/yr

Manages resolution of service issues between customers, brokers, business units and support service ... Experience in insurance industry operations and systems * Experience with Microsoft Office ...

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Tpa Operations Manager information

What is a TPA Operations Manager?

TPA Operations Managers oversee the daily operations of Third Party Administrator (TPA) organizations, which often manage insurance claims, employee benefits, or administrative services for other companies. They are responsible for ensuring efficient workflows, compliance with regulations, and high-quality service delivery. TPA Operations Managers coordinate teams, streamline processes, and resolve issues to meet client expectations. Their role is crucial for maintaining smooth operations and building strong client relationships.

What are the key skills and qualifications needed to thrive as a TPA Operations Manager?

To thrive as a TPA Operations Manager, you need expertise in insurance operations, process optimization, and regulatory compliance, typically supported by a bachelor's degree in business or a related field. Familiarity with claims management systems, analytics tools, and industry certifications like AINS or CPCU is valuable. Strong leadership, problem-solving, and effective communication skills help drive team performance and client satisfaction. These skills are crucial for ensuring operational efficiency, regulatory adherence, and the delivery of high-quality service in third-party administration.

What are some common challenges faced by a TPA Operations Manager and how can they be addressed?

A TPA (Third Party Administrator) Operations Manager often faces challenges such as ensuring compliance with ever-changing regulations, managing diverse client requirements, and maintaining efficient claim processing. Balancing operational efficiency with high-quality customer service can also be demanding, especially during peak periods. Effective solutions include implementing robust process automation, continuous staff training, and fostering clear communication between internal teams and external clients. Staying proactive with regulatory updates and leveraging technology can help streamline operations and reduce errors.

What is the difference between Tpa Operations Manager vs Claims Supervisor?

AspectTpa Operations ManagerClaims Supervisor
CredentialsTypically requires a bachelor's degree in business, insurance, or related field; certifications like CPCU or ARM are commonUsually requires a bachelor's degree; certifications like CPCU or similar are advantageous
Work EnvironmentManages operations within third-party administrator (TPA) companies, overseeing multiple teams and processesSupervises claims processing teams within insurance companies or TPAs, focusing on claims handling
Employer & Industry UsageFound in TPA firms, insurance companies, and healthcare organizationsCommon in insurance carriers, TPAs, and claims departments

The Tpa Operations Manager oversees overall TPA operations, including process improvements and team management, while the Claims Supervisor focuses specifically on managing claims processing teams. Both roles require similar credentials and work in related environments, but their scope differs: one manages broader operations, the other concentrates on claims handling.

What cities in Texas are hiring for Tpa Operations Manager jobs?

Cities in Texas with the most Tpa Operations Manager job openings:

TPA Services Manager

Austin, TX

BC&L INC
See more jobs at BC&L INCexternal

Full-time

Re-posted 3 days ago

Key responsibilities

  • Supervise and coordinate core TPA operations including claims processing, member services, and special projects.

  • Oversee daily claims intake, adjudication, payment workflows, and monitor claims inventory to ensure accuracy and timely processing.

  • Manage daily call center operations, handle escalated member inquiries, and track performance metrics.

Job description

The TPA Services Manager is responsible for the daily supervision and coordination of core TPA operations, including claims processing, member services and assigned special projects. This role ensures that operational workflows run efficiently, service standards are met, and staff are supported in delivering accurate and timely results. The Manager works closely with the Director of TPA Services to implement departmental goals and serves as a key point of escalation for team leads and staff.

Key responsibilities may include:

  • Claims Processing
    • Supervise day-to-day claims intake, adjudication, and payment workflows to ensure accuracy and timely turnaround.
    • Monitor claims inventory and production queues; identify and resolve backlogs or processing errors.
    • Conduct routine audits and quality checks; report error trends and support corrective action plans.
    • Assist staff with complex or escalated claims questions; coordinate with plan documents and benefit summaries.
    • Ensure claims operations remain compliant with ERISA, HIPAA, and applicable plan requirements.
  • Member Services & Call Center
    • Oversee daily call center operations including staff scheduling, queue monitoring, and real-time performance tracking.
    • Coach and support member services representatives to maintain call quality, accuracy, and professionalism.
    • Handle escalated member inquiries, complaints, and grievances in a timely and empathetic manner.
    • Track and report on call center KPIs (first-call resolution, handle time, member satisfaction) and flag areas for improvement.
  • Special Projects
    • Manage assigned operational projects such as process improvement initiatives, system upgrades, or client onboarding support.
    • Develop project task lists, coordinate team participation, and track progress against defined timelines.
    • Communicate project status updates to the Director and relevant stakeholders.
    • Document new or revised workflows and ensure staff are trained on updated procedures.
  • Team Leadership & Administration
    • Directly supervise TPA operations staff; conduct performance check-ins, provide feedback, and support professional development.
    • Assist with onboarding and training of new team members across all functional areas.
    • Foster a collaborative, accountable team environment focused on quality and member service.
    • Prepare operational reports and dashboards for leadership review on a regular cadence.

Required

  • Bachelor’s degree in Business, Healthcare Administration, Insurance, or a related field; or equivalent work experience.
  • 3–5 years of experience in TPA operations, health insurance claims, or managed care administration.
  • 1–2 years of supervisory or team lead experience.
  • Working knowledge of claims processing, member services operations, and stop loss concepts.
  • Familiarity with ERISA, HIPAA, and self-funded health plan administration basics.
  • Strong organizational skills and ability to manage multiple priorities in a deadline-driven environment.
  • Proficient in Microsoft Office and claims management or benefits administration systems.

Preferred

  • Professional certification such as CEBS, AHM, or equivalent.
  • Experience with self-funded employer group administration.
  • Experience with TPA platforms (e.g., DialPad, ElDorado, or similar).

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