Manages and supervises the Claims Team to ensure claims are paid properly and timely in accordance with Regulatory standards, Health Net standards, and contractual obligations
Job Summary
Manages and supervises the Claims Team to ensure claims are paid properly and timely in accordance with Regulatory standards, Health Net standards, and contractual obligations.
Identifies problem areas such as understaffing, customer complaints/issues, inefficiencies, and takes corrective action.
Handles all personnel related duties such as counselling, interviewing, performance review, hiring and terminations.
Matching Summary
Manages and supervises the Claims Team to ensure claims are paid properly and timely in accordance with Regulatory standards, Health Net standards, and contractual obligations.
Skills & Requirements
Must-have
Medicare Advantage program experience
Medical terminology knowledge
Claim processing procedures/systems
CMS regulations compliance
HIPAA knowledge
Microsoft Office Suite (Excel)
Nice-to-have
Value added options for client
Employee development plans
Team leadership and mentoring
Exceptional customer service skills
Key Requirements
High school diploma or equivalent
Minimum 6 months Medicare Advantage experience
Supervise others experience
Interviewing and hiring experience preferred
Budgeting cost estimating and fiscal management principles