Pay range: $85,904 - $128,856 annually, based on experience.

In addition, this role is eligible to work remotely from an approved state by St. Charles (please refer to the list). If you do not reside in an approved listed state (or do not plan to relocate to an approved listed state) we request, you do not apply for this particular position.

Approved states by St. Charles: Oregon, Arizona, Arkansas, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Tennessee, Utah, and Wisconsin.

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE: Manager, Claims

REPORTS TO POSITION: Senior Director, Single Billing Office

DEPARTMENT: Single Billing Office

DATE LAST REVIEWED: July 2026

DEPARTMENTAL SUMMARY: The Single Billing Office (SBO) at St. Charles Health System (SCHS) provides revenue cycle services to our multi-hospital and medical group organization focusing on billing, collecting, and posting revenue. The goal of the SBO is to deliver a delightful, transparent, and seamless experience to patients and customers that captures and collects the revenue earned by SCHS in a quality, efficient and timely manner. Services include but are not limited to: billing insurance claims, posting insurance and patient payments, resolving insurance denials, collecting unpaid insurance claims, maintaining payer contracts in the EMR, resolving under and over payments, identifying and resolving payer issues, processing refunds, processing financial assistance applications, billing patients, resolving patient accounts including patient questions, and vendor management: lockbox, third-party collections, clearinghouse, early out, collection agencies.

POSITION OVERVIEW: The Claims Manager at St. Charles Health System is responsible for leading the daily operations of the claims function, including billing and insurance follow-up, to optimize reimbursement and support organizational revenue cycle goals. This role oversees claims operations, drives denial prevention and resolution efforts, analyzes claims performance, and implements process improvements that enhance efficiency, compliance, and financial outcomes. The Claims Manager collaborates with clinical, operational, and revenue cycle leaders to resolve complex claims issues, ensure adherence to billing regulations and payer requirements, and promote best practices across the organization. The position provides leadership, coaching, and development for claims supervisors and caregivers while fostering a culture of accountability, continuous improvement, and exceptional service.

This position directly supervises other caregivers.

ESSENTIAL DUTIES AND FUNCTIONS:

Manages the overall operations of claims teams.

Develops and maintains department policies and procedures.

Manages the creation and maintenance of training manuals, guides, and standard work.

Attends and/or leads applicable meetings including huddles, staff meetings, payer meetings, clinical and support department meetings, and educational opportunities as appropriate.

Maintains strong working knowledge of billing regulations, coding guidelines, reimbursement methodologies, and industry best practices.

Identifies denial trends in coordination with claim teams and other leader through the completion of audits, claim reviews, data analysis, research, and education.

Monitors revenue cycle metrics and implements solutions to meet metrics including education, IT optimization, and collaborations with departments, payers, and vendors. Solutions may include writing decision papers, SBAR's, or presenting content to applicable stakeholders.

Point person for claim level escalations. Solutions to escalations may include writing decision papers, SBAR's, or presenting content to applicable stakeholders.

Supports SCHS Single Billing Office (SBO) senior director as needed.

Supports Senior Director in budget development, regular monitoring, accountability and meeting all operational targets for all areas within span of control.

Manages human resource tasks including interviewing, hiring, timekeeping, coaching, mentoring, and performance management.

Hires, directs, coaches, and monitors the performance of all direct reports, to develop and maintain a high-performance team that meets organizational and department goals.

Monitors and ensures all direct reports are current with compliance and safety requirements. Implements and manages all organizational safety directives and goals.

Provides and oversees team's delivery of customer service in a manner that promotes goodwill, is timely, efficient, and accurate.

Collaborates with teams to review processes and identify/implement opportunities for improvements, applying Lean principles, concepts, and tools.

Supports the vision, mission, and values of the organization in all respects.

Supports Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Delivers customer service in a manner that promotes goodwill and teamwork; timely, efficient, and accurate.

Collaborates with teams to review processes and identify/implement opportunities for improvements, applying Value Improvement Practice concepts and tools.

Provides and maintains a safe environment for caregivers, patients, and guests.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the organization's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

May perform additional duties of similar complexity within the organization, as required or assigned.

EDUCATION:

Required: Bachelor's degree in related field. A combination of education and relevant prior experience may be substituted in lieu of a degree.

Preferred: N/A

LICENSURE/CERTIFICATION/REGISTRATION:

Required: N/A

Preferred: Applicable revenue cycle certification including coding, compliance, and billing.

EXPERIENCE:

Required: Five years of applicable revenue cycle and/or patient financial services experience. Two years of experience in a finance field may substitute for two years' experience. One year of leadership experience.

Preferred: Epic and vendor management experience.

PERSONAL PROTECTIVE EQUIPMENT:

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

ADDITIONAL POSITION INFORMATION:

Travel: Ability to travel to business functions/trainings/meetings and all SCHS worksites required.

Advanced knowledge of healthcare industry, billing and collection practices, revenue cycle processes and payer reimbursement methodologies.

Strong communication skills, including public speaking and technical writing.

Demonstrated research and problem-solving skills.

Ability to operate and make decisions independently.

Process improvement experience/skills.

Intermediate skills in Microsoft Office applications: Excel, One Note, Outlook, Teams, Power Point, and Word.

PHYSICAL REQUIREMENTS:
Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level.
Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.
Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing.
Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-25 pounds, operation of a motor vehicle.
Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level.
Exposure to Elemental Factors
Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface.
Blood-Borne Pathogen (BBP) Exposure Category
No Risk for Exposure to BBP

Schedule Weekly Hours:
40

Caregiver Type:
Regular

Shift:
First Shift (United States of America)

Is Exempt Position?
Yes

Job Family:
MANAGER

Scheduled Days of the Week:
Monday-Friday

Shift Start & End Time:
8:00 - 5:00