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358 Manager, Claim Operations Job
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| Employer Name: |
SpiderID: 2471760 |
| Location: Boston, Massachusetts |
Date Posted: 9/5/2008 |
| Wage: |
Category: Insurance |
| Job Code: 358 |
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Job Description:
1. Under the direction of the Medicare Preferred Director of Claims, the Manager will provide intense management focus on the daily production of claims.
2. The manager is responsible for the oversight, implementation and ongoing maintenance of the day- to-day work of claims functions. This includes responsibility for the efficient, accurate, and timely processing of all claims and encounters.
3. The manager must ensure that staff productivity and quality goals are met and aggressively manage employee performance. This includes the assessment of employee needs, making the right tools and references available, as well as overseeing coaching, goal setting, and the corrective action process.
4. The manager, along with rest of the claims management team, is responsible for identifying and participating in the design and implementation of modifications to the system that will improve the efficiency and accuracy of claims processing.
5. The incumbent will manage a staff of multiple supervisors and a processing and support staff ensuring compliance with Company and CMS (Centers for Medicare and Medicaid Services) standards.
Job Requirements:
1. Undergraduate degree preferably in healthcare or business / management or comparable work experience equivalent.
2. Five years or more of progressively responsible health care operations management experience is required.
3. A thorough knowledge of managed health care including excellent knowledge of claims processing.
4. Must also have excellent verbal and written communication skills.
5. Must demonstrate proficiency with staff management and development.
6. This job requires a high level of analytical ability, initiative and judgment combined with the ability to manage in an extremely complex and fast paced environment.
7. Must have an operational, management and system perspective to effectively develop and manage a rapidly growing product.
8. Excellent interpersonal skills are required as well as a high level of diplomacy, sufficient to interact with internal departments and a diversity of other professionals including high-level hospital personnel and providers via contact by phone, in person and in writing.
**Email resumes as attachment in Word Format
Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required: 5
Education Required:
Overnight Travel:
Vacation Time:
Contact Information:
| Contact Name: Nina Candido |
Company Type: |
| Company: GRN of Utica |
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| City: Clinton |
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| State: New York |
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| Zip: |
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Web Site: http://www.grnutica.com
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