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amps

Your Holistic Approach to Healthcare Cost Savings Solutions

Claims Manager

ManagerManagerFull TimeRemoteLeadTeam 201-500Since 2005H1B No SponsorCompany SiteLinkedIn

Location

Arizona

Posted

7 days ago

Salary

0

Seniority

Lead

Bachelor Degree7 yrs expEnglish

Job Description

Claims Manager

amps

• Maintain HIPAA/PII guidelines to ensure the confidentiality of all calls and documents • Serve as a liaison between departments, vendors and clients to ensure collaborative progress • Exhibit strong working knowledge of customer business operations • Demonstrate strategic business acumen in decisions affecting bottom line focus • Generate and deliver accurate and timely reports • Assist with troubleshooting for technical issues • Serve as a role model in demonstrating core values of customer service • Encourage continuous learning, personal development and accountability through team members • Provide timely and thorough responses to internal and external customers • Respond to member and group correspondences regarding plan/guideline or claim questions within 24 hours • Escalate difficult issues to the appropriate channels • Assist in the processing and resolution of escalated issues • Ensure team compliance with service standards • Follow trends within assigned scope and alert appropriate parties of any trends that fall outside quality parameters • Develop and execute plans to meet established goals • Provide continuous feedback to strengthen and optimize quality performance • Work cross-departmentally to improve or streamline procedures • Maintain up to date knowledge on industry trends and look for new data sources • Develop new and improve current internal processes to improve overall quality • Conduct regular performance evaluations of employees and provide ongoing feedback and coaching as necessary • Address and counsel employees on behavioral or performance problems and implement corrective action as necessary • Explain and administer company policies required for team members to perform duties successfully • Distribute and monitor departmental workloads to ensure adequate coverage while meeting quality and service levels • Oversee new and ongoing training and update training manuals • Coordinate and actively participate in departmental meetings

Job Requirements

  • College degree or equivalent required
  • Degree in Medical Billing and Coding or related field preferred
  • Knowledge of medical terminology preferred
  • 7 -10 years Claims Examiner experience or equivalent required
  • 4 -7 years management experience required

Benefits

  • Health insurance
  • 401(k) matching
  • Paid time off
  • Flexible work arrangements
  • Professional development opportunities

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