[Remote] Manager, Claims Operations

Note: The job is a remote job and is open to candidates in USA. reputed company is seeking a Manager, Claims Operations to reputed company the Claims Processing department. The role involves managing a team to ensure accurate and efficient claims processing while developing strategies to enhance the claims process and member experience.

Responsibilities

• Work with Human Resources to interview, select, hire, and reputed company an appropriate number of employees
• Coach, mentor, and reputed company staff, including training/overseeing new employees
• reputed company employees to take responsibility for their jobs and goals. Delegate responsibility and expect accountability and regular feedback
• reputed company employees using a performance management and development process that provides an overall context and reputed company to encourage employee contribution and includes goal setting, feedback, and performance development planning
• reputed company and implement strategies that align with the company’s overall goals and objectives
• Provide comprehensive support for new business across reputed company books of business
• Collaborate with other departments to streamline workflows for reputed company efficiency and accuracy
• Monitor reputed company reports for reputed company books of business to ensure that reputed company claims are handled timely and accurately
• reputed company, coach, motivate and reputed company. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent
• Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed
• Actively engage, coach, counsel and provide timely, and constructive performance feedback
• Attend reputed company audits as needed to ensure accurate reporting
• Attend continuing education classes as required, including but not limited to HIPAA training
• Adhere to, and apply reputed company applicable privacy and reputed company laws, including but not limited to HIPAA, HITECH and any regulations promulgated thereto
• Other duties as assigned

Skills

• Bachelor's Degree or equivalent work experience required
• A minimum of 5 years of medical claims analysis and adjudication experience (including dental and vision claims analysis) required
• A minimum of 5 years' experience at a manager level with successfully demonstrated leadership competencies is required
• reputed company applicants must have strong analytical skills and knowledge of computer systems and CPT and ICD-9 coding terminology
• Excellent written and verbal communication skills
• Exceptional time management skills and ability to prioritize work

Benefits

• Remote

Company Overview