Responsible for the management of operations for the claims department. Oversees and coordinates claim team auditing efforts. Provides guidance and sets departmental policies for department. Utilizes extensive expertise and judgment in a variety of field concepts, practices and procedures to drive and ensure optimal outcomes. Exhibit strong organizational skills through management of department and client performance metrics; quality, production, TAT and SLA's. Identify and drive all claims department projects and development opportunities. Utilize and enhance reporting tools to improve accuracy of results. Possess excellent written and oral communication skills to aid in conducting business meetings for both internal and external customers to include healthcare providers and health plans. Oversee the creation and maintenance of Claims Department Policies, Procedure manuals and training materials. Manages resources within budget requirements and exhibit strong organizational skills. Provide guidance and mentoring to direct reports for improvement of individual and collective skills. Motivate and guide team to meet and exceed goals and objectives. Other responsibilities as necessary.
Minimum Experience Required
Bachelor's degree in related field and/or minimum of 5-7 years of experience in a healthcare claims production environment
Minimum 5 years management or supervisory role experience.
Extensive HealthCare Reimbursement Knowledge
Extensive HealthCare Knowledge
Strong conflict management, commuinication and interpersonal skills.
Ability to develop strong relationships with internal and external clients.
Our Company and What We Offer
Core healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. evi
Core offers a variety of perks and benefits including, but not limited to:
Flexible scheduling and work/life balance with remote and work from home opportunities
3 weeks of PTO(starting) per year plus paid holidays
Education assistance, tuition reimbursement and professional certifications
Health, dental, vision, and life benefits with employer funded HSA
Comprehensive employee discount program, onsite fitness facilities, and smart casual dress code
Paid Volunteer Community Service Days
Ample opportunities for growth, advancement, and promotion
401k retirement plan with company match of 50% employee contributions up to 6%