Director of Eligibility
Director of Eligibility
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Job Description
Overview
NaphCare is hiring an experienced Director of Eligibility to join our team at the Corporate 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 35 years. Come join our team of over 6000 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 Benefits for FullTime Employees Include:
- Prescriptions free of chargethrough our health plan
- Health dental & vision insurance thatstarts day one!
- Lowest Cost Benefitsfor Employee and their Family!
- Employment Assistance Program (EAP) services
- 401K and Roth with company contribution that starts day one!
- Tuition Assistance
- Referral bonuses
- Onsite education
- Free Continuing Education!
- Term life insurance at no cost to the employee
- Generous paid time off & paid holidays
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 for the Director of Claims Management:
- Understanding and applying federal state and local laws & policies related to patient eligibility.
- Establish patient eligibility and enrollment guidelines based on contractual requirements with clients.
- Develop and maintain system designed to determine financial responsibility of patient medical claims.
- Provide direction to Eligibility Team.
- Analyze reports and review internal audits to ensure benchmarks are met.
- Manage timecards coordinate time off requests and coverage.
- Appropriately communicate information both verbally and in writing to clients team members and executive management.
- 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.
- 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 eligibility process.
- Additional duties and specific projects as assigned.
- Reports to Vice President Claims Administration.
Qualifications
Qualification for the Director of Claims Management:
- Bachelors degree required.
- 5 years Sr. Manager Business Operations.
- 5 years supervisory/managerial experience in Revenue Cycle.
- Knowledge of Medicaid Medicare and ACA programs.
- 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
#CorrectionalAdvanced Emergency Medical Technicians#Jail
Required Experience:
Director
Employment Type
Full-Time
