Claims - Manager, Claims

Wellcove/CHCS-Services • Pensacola, FL

5d

About The Position

We are seeking a dedicated and detail-oriented Claims Manager to oversee the claims process within our organization. The ideal candidate will have a strong background in claims management and possess excellent negotiation and organizational skills. This role involves managing a team, ensuring compliance with policies, and optimizing the claims process to enhance customer satisfaction. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Requirements

• Proven experience in claims management or a related field is essential.
• Familiarity with medical billing, medical coding, and financial software is highly desirable.
• Strong organizational skills with the ability to manage multiple priorities effectively.
• Excellent negotiation skills and a solid understanding of risk management principles.
• Proficient in clerical tasks associated with claims processing.

Nice To Haves

• Knowledge of mold remediation processes or automotive repair may be beneficial but not required.

Responsibilities

• Lead and manage the claims department, ensuring efficient processing of claims.
• Review and assess claims for accuracy, completeness, and compliance with company policies.
• Collaborate with various departments to gather necessary information for claim resolution.
• Maintain up-to-date knowledge of industry regulations, medical terminology, and financial software relevant to claims processing.
• Implement risk management strategies to minimize potential losses associated with claims.
• Provide training and support to staff on medical billing, coding, and clerical tasks related to claims management.
• Develop reports on claims trends and present findings to senior management.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed