Claims Manager Jobs

About The Position

Requirements

• Two to four years of management and claims experience.
• Computer literacy and proficiency with spreadsheet and word-processing applications.
• Excellent written and verbal communication skills.
• Excellent leadership and interpersonal skills, including the ability to establish confidence and rapport and foster cooperative relationships with clients, providers, and coworkers.
• Understanding of self-funded payer claims policies and Federal, State, and other regulations pertaining to health insurance claims payment, including TPL, COB, coding, and reimbursement methodologies.
• Experience with automated claims systems.
• Ability to maintain sound production operations.

Responsibilities

• Assist with staff supervision, including training, planning, and directing work.
• Respond to staff and internal and external customer inquiries and resolve issues.
• Research and respond to customer calls as the first point of contact.
• Manage assigned tasks, queues, and inventory within department guidelines.
• Manage internal emails and coordinate with staff to provide timely responses.
• Collaborate with the reporting manager to meet turnaround times, quality standards, and company goals.
• Trend assignment errors, identify staff training needs, and collaborate with quality assurance on unit module updates.
• Attend staff meetings and assist with delivering materials, training, and communications.
• Assist in coordinating workflow and controlling work procedures.
• Provide subordinates with guidance on general claims and escalated issues.
• Communicate with clients, providers, and internal and external areas.
• Follow company and department policies and procedures and departmental timeliness expectations.
• Occasionally travel to client locations.
• Perform other duties as assigned.