MGR, CLAIMS - Alabama Community Care Team

Location
Virginia Beach, VA
Posted
Apr 20, 2017
Closes
May 31, 2017
Function
Nurse
Industry
Healthcare
Hours
Full Time
Job Description:
Optima Health has an opening for a MGR CLAIMS. This position is full time, day shift and located at our Virginia Beach, VA operations center in support of our Alabama Community Care team.

Claims Manager is responsible for sustaining and developing departmental policies and procedures, providing oversight to staff responsible for claims processing activities, and ensuring that the organization¿s service, quality, productivity, and financial standards or goals are achieved. Oversee high dollar, complex claims auditing, monitor claims interest, perform detailed claims analyses and compose correspondence and/or detailed reports. Monitor and oversee direct reports to include Team Coordinators and employees. Assist with internal and external audits by thoroughly analyzing all errors and grievances. Create new claims policies or make recommendations to existing policies in the Claims P&P

Education Level
Bachelor's Level Degree

Experience
Required: Related - 3 years

Preferred: None, unless noted in the “Other” section below

License
None, unless noted in the “Other” section below

Skills
None, unless noted in the “Other” section below

Other
3 years of health plans claims disbursements required