Director Of Claims Management
Director Of Claims Management
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1 Vacancy
Job Description
Overview
NaphCarehas an excellent opportunity for aDirector of Claims Managementto join ourCorporate HeadquartersinBirmingham AL.
NaphCare is a family owned medical technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 30 years. Come join our team of over 4000 employees and growing!NaphCare pays well offers outstanding benefits and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do.
NaphCare partners with correctional facilities to provide proactive patientfocused healthcare. We recognize that we serve a unique and diverse patient population and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a worldclass team of professionals who are revolutionizing correctional healthcare as you use our cuttingedge resources including our awardwinning electronic operating system.
NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are uptodate. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing.
With NaphCare youll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry. If you want a career that will make a difference choose the company that is different.
We support your growth and internal promotion. Once hired we encourage our employees to continue to seek opportunities for advancement and leadership.
Responsibilities
Responsibilities:
- Develop long term plan for claims organization as the division continues its growth path.
- Establish and monitor benchmarks and metrics for team performance.
- Provide direction and oversite to departmental Claim Managers.
- Analyze reports and review internal audits to ensure benchmarks are met.
- Manage timecards coordinate time off requests and coverage.
- Handle escalations with Claims team members clients and providers to ensure a resolution is achieved.
- Appropriately communicate information both verbally and in writing to clients team members and supervisors.
- Communicate with other departments as needed to ensure claims are processed accurately and timely.
- Train all new employees and coordinate ongoing training for current team members to ensure all NaphCare processes and job functions are followed.
- Delegate tasks to the team appropriately and provide support to the team members.
- Utilize medical terminology knowledge to review claims medical records and authorization scenarios.
- Exhibit a high comfort level in working with large volumes of data.
- Demonstrate a strong attention to detail and a commitment to customer service throughout the claims process.
- Work closely with the Vice President of Claims Management to ensure claims processes and systems are operating as expected.
- Additional duties and specific projects as assigned.
Qualifications
Qualifications:
- Bachelors degree required
- 5 years supervisory/managerial experience in medical claims adjudication.
- 5 years of medical claims processing.
- Medicare/Medicaid claims processing experience preferred.
- Knowledge of Medicare guidelines and payment methodologies.
- Knowledge of medical terminology ICD9 HCPCS and CPT coding and an ability to understand medical records.
- Strong leadership and training skills.
- Strong Human Resource skills.
- Strong followup skills.
- Excellence in Microsoft Office Suite and strong written and verbal communication skills required.
We know you may have questions before applying.To speak to a recruiter directly email your questions and/or resume towith the position and location youre interested in.
Equal Opportunity Employer: disability/veteran
Required Experience:
Director
Employment Type
Full-Time
