Job Description

Job Title: Claims Manager (TPA)

Job Location: Charlotte, NC

Company Website:

Company Summary:

90 Degree Benefits is a health benefits company that specializes in designing health plans and administering benefits for self-funded employers. With a fully integrated, comprehensive medical risk management program that improves health care outcomes for plan participants, the 90 Degree Benefits team of experts is able to significantly reduce claim costs for employer clients. Like all of the 90 Degree Benefits locations, the Charlotte, NC office serves employers and their members both locally and nationwide. As leaders in the industry, the 90 Degree Benefits team in Charlotte takes pride in guiding clients on the road to achieving more with their health plan.

Position Summary:

90 Degree Benefits is seeking a full-time Claims Manager with Third Party Administrator (TPA) experience to lead our claims department. This role is responsible for ensuring accurate, compliant, and timely claims processing, while managing a team of processors and auditors.

Essential Duties and Responsibilities:

• Oversee the daily operations of the claims department
• Manage and support a team to meet performance and audit standards
• Review complex claims and determine resolutions
• Collaborate with internal teams (IT, account management, customer service)
• Monitor claims turnaround time and reporting metrics
• Handle appeals, Medicare demands, and subrogation cases
• Ensure compliance with HIPAA, COBRA, and other federal/state regulations
• Assist in training new staff and updating procedures

Qualifications:

• TPA (Third Party Administrator) experience required
• Strong leadership and decision-making skills
• Experience with medical, dental, RX, and disability claims
• Knowledge of auditing, appeals, coordination of benefits, DRG/PPO/RBP admin
• Excellent communication and analytical skills
• Bachelor’s degree preferred
• Manage and support a team to meet performance and audit standards
• Review complex claims and determine resolutions
• Collaborate with internal teams (IT, account management, customer service)
• Monitor claims turnaround time and reporting metrics
• Handle appeals, Medicare demands, and subrogation cases
• Ensure compliance with HIPAA, COBRA, and other federal/state regulations
• Assist in training new staff and updating procedures

Pay:

$65,000 - $70,000 per year

Benefits:

Health Insurance

Paid Time Off

Dental Insurance

401K

Vision Insurance

Life Insurance

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