Medical Claims Director

Turn Key Health Clinics • Oklahoma City, OK

452d • $60,000 - $80,000

About The Position

The Medical Claims Director at Turn Key Health Clinics is responsible for overseeing the strategic processing of medical claims within a correctional healthcare environment. This role involves ensuring compliance with federal, state, and local regulations while managing a team dedicated to timely claims processing. The position requires strong leadership skills and the ability to build relationships with various stakeholders in the healthcare and correctional sectors.

Requirements

• 5 plus years of medical claims processing experience required.
• Bachelor's Degree in a related field (preferred).
• Knowledge of Federal, State, and County regulations and laws regarding medical claims (correctional knowledge a bonus).
• Management experience (preferred).
• Knowledge of Medicaid claims processing (preferred).

Responsibilities

• Obtain knowledge on correctional medical claims processing and research new legislation and guidelines.
• Work with the legal team to address and research regulatory requirements related to claims.
• Manage day-to-day activities of the claims team and ensure timely processing of medical claims.
• Develop and adhere to department policies and procedures that align with company needs.
• Build and maintain relationships with healthcare institutes, correctional partners, and team members.
• Coordinate necessary communication for all affected parties related to claims issues.
• Monitor claim activities, performance management, and production standards and quality of results.
• Work with the accounting department to ensure proper payment processing.
• Produce monthly reports and share with appropriate parties in a timely manner.
• Process claims as needed.

Benefits

• Competitive salary ranging from $60,000 to $80,000 per year.
• Full-time employment with a standard 40-hour work week, Monday to Friday.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree