Call Center Claims Operations Manager

Call Center Claims Operations Manager

Location: Amherst, NY
Salary: Starting at $55,000 annually
Employment Type: Full-Time
Work Arrangement: On-Site – Amherst, NY
Schedule: Monday–Friday, 9:30 AM–6:00 PM EST

About LEC

LEC is seeking an experienced and motivated CSC Operations Manager to oversee our team of remote Healthcare Administrative Claims Agents. This role is responsible for ensuring day-to-day operations run efficiently while maintaining high standards for productivity, quality, accuracy, client service, and compliance.

The ideal candidate is a strong people leader who understands call center operations, healthcare administration, insurance claims, or revenue cycle processes and can effectively coach a team that communicates directly with insurance carriers and payer representatives.

Position Summary

The Operations Manager will manage, coach, and support a team of remote Claims Specialists responsible for outbound insurance calls, claims follow-up, eligibility verification, provider credentialing inquiries, prior authorization status checks, and detailed documentation.

This position will serve as a key connection between LEC leadership, remote agents, and clients. The Operations Manager will monitor team performance, identify opportunities for improvement, resolve operational issues, and ensure agents consistently follow established procedures and client requirements.

Key ResponsibilitiesTeam Leadership & Management

• Directly manage and support a team of remote Healthcare Administrative Claims Agents.
• Provide daily leadership, direction, coaching, and accountability to team members.
• Monitor attendance, schedules, workload, productivity, and overall team performance.
• Conduct regular one-on-one meetings, coaching sessions, and performance reviews.
• Identify employee strengths and development opportunities.
• Address performance concerns professionally and consistently.
• Promote a positive, accountable, and team-oriented work environment.

Operations & Workflow Management

• Oversee daily claims follow-up and healthcare administrative operations.
• Ensure agents follow established processes, scripts, workflows, and client-specific requirements.
• Monitor work queues and ensure tasks are completed accurately and within required timeframes.
• Identify workflow bottlenecks and implement process improvements.
• Ensure appropriate coverage and distribution of work across the team.
• Escalate operational issues and client concerns when appropriate.
• Help develop and maintain standard operating procedures and training materials.

Quality & Performance

• Monitor key performance indicators, including productivity, quality, accuracy, call activity, documentation, and task completion.
• Conduct quality reviews of agent work and documentation.
• Provide actionable feedback and coaching based on performance results.
• Ensure agents accurately document insurance calls, claim statuses, payer responses, and follow-up requirements.
• Track team performance against client expectations and internal goals.
• Develop corrective action and improvement plans when necessary.

Healthcare Claims & Payer Support

The Operations Manager should understand or be willing to learn the processes performed by the Claims Specialist team, including:

• Claim status follow-up for processed, approved, denied, delayed, and paid claims.
• Claim adjudication and payment timeline inquiries.
• Requests for missing documentation and clarification of denial reasons.
• Appeal requirements and prior authorization status.
• Eligibility verification.
• Provider credentialing status checks.
• Navigating insurance payer IVR systems.
• Communicating with claims representatives and payer personnel.
• Accurately documenting call outcomes and required follow-up activities.

Training & Development

• Assist with onboarding and training new Claims Specialists.
• Reinforce proper call handling, documentation, and payer inquiry procedures.
• Identify recurring training needs and coordinate refresher training.
• Help agents improve communication, productivity, accuracy, and system proficiency.
• Maintain consistency in processes across the team.

Client & Internal Communication

• Serve as an escalation point for agent questions and operational issues.
• Communicate effectively with LEC leadership regarding team performance and operational needs.
• Assist with client communications and service-related escalations.
• Ensure client expectations and process changes are communicated clearly to the team.
• Provide regular reporting and updates regarding team performance and operational trends.

Qualifications

• 2+ years of management, supervisory, or team-lead experience, preferably in a call center, healthcare, insurance, claims, or administrative environment.
• Healthcare, insurance claims, medical billing, or revenue cycle experience strongly preferred.
• Experience managing remote or distributed teams is a plus.
• Strong understanding of call center performance metrics and quality standards.
• Excellent verbal and written communication skills.
• Strong leadership, coaching, problem-solving, and conflict-resolution abilities.
• Highly organized with strong attention to detail.
• Comfortable working with multiple computer systems and platforms.
• Ability to analyze performance data and identify trends or opportunities for improvement.
• Ability to enforce policies and procedures while maintaining positive employee relationships.
• Strong time-management and multitasking skills.
• High School Diploma or equivalent required; college degree or relevant professional experience preferred.

What We're Looking For

The successful candidate will be a hands-on leader who is comfortable balancing people management, performance management, and day-to-day operations.

You should be someone who:

• Leads by example.
• Holds team members accountable while providing meaningful support.
• Is comfortable having difficult conversations when necessary.
• Uses data and performance metrics to make decisions.
• Can identify problems and develop practical solutions.
• Communicates clearly and professionally.
• Understands the importance of accuracy and documentation in healthcare administration.
• Can effectively manage employees working remotely while maintaining engagement and accountability.

Position Details

Salary: Starting at $55,000 annually, with potential for additional compensation based on experience and qualifications.

Location: Amherst, NY – On-Site

Schedule: Monday–Friday, 9:30 AM–6:00 PM EST

Employment Type: Full-Time

Why Join LEC?

This is an opportunity to take a leadership role in a growing healthcare administrative operation and directly contribute to the success of a remote team serving healthcare clients across the country.

If you're an organized, results-driven leader who enjoys developing people and improving operations, we'd like to hear from you.

Apply today to join LEC as our next Operations Manager.