Claims Review Manager
About The Position
NaphCare has an excellent opportunity for a Claims Review Manager to join our Corporate Headquarters in Birmingham, AL supporting our scheduling teams. The successful Claims Review Manager will play a critical role in our operations by overseeing a team of claims specialists that review authorizations for medical procedures/appointments and reconciling claims. This position requires data entry skills and the ability to maintain a high volume of work with minimal errors. This employee will serve as a liaison between the scheduling and claims department to assist with timely processing of claims.
Requirements
- High School Diploma or equivalent required
- Three (3) years minimum experience in a healthcare claims, billing or medical authorization setting.
- Ability to prioritize, delegate, and meet deadlines in a high volume environment.
- Working knowledge of medical claims, medical terminology, medical records, and medical authorization processes.
- Strong written, verbal and organizational skills.
- Working knowledge of claim demographic information.
- Computer skills, including proficiency in Microsoft Office Suite, particularly Excel.
Nice To Haves
- Associate's or Bachelor's degree in healthcare administration, business, or a related field preferred.
Responsibilities
- Utilize healthcare experience to consistently review medical authorizations in our scheduling system in order to resolve outstanding claims
- Demonstrate skills in accuracy and multitasking while working to impact progress within the daily workload and adhere to internal deadlines
- Manage team of Claims Review Specialists to ensure that claims are being worked timely with minimal errors
- Develop and deliver regular reports on team analytics and key performance metrics
- Independently identify and resolve operational challenges, and proactively recommend and implement improvements to processes and workflows that increase efficiency and accuracy
- Maintain confidentiality when managing medical records, patient data, and NaphCare processes
- Demonstrate a high comfort level in working with large volumes of data
- Demonstrate a strong attention to detail
- Additional duties and specific projects as assigned
Benefits
- Health, dental & vision insurance that starts day one!
- Prescriptions free of charge through our health plan, beginning day one!
- Lowest Cost Benefits!
- Employee Assistance Program (EAP) services
- 401K and Roth with company contribution that starts day one!
- Tuition Assistance
- Referral bonuses
- Term life insurance at no cost to the employee
- Generous paid time off & paid holidays
- Free continuing education and CMEs
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
High school or GED
