Claims Manager

🕒 il y a 20 jours

🌵 Arizona – Distant

🌵 Arizona – Remote

⏰ Temps Plein

🟠 Senior

🔴 Expert

👔 Manager

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amps

Site WebLinkedInTous les Emplois

201 - 500 employés

Fondée en 2005

⚕️ Assurance santé

💳 Fintech

🤝 B2B

Healthcare Insurance • Fintech • B2B

AMPS est un leader dans la réduction des coûts de santé pour les organisations autofinancées, dédié à transformer la gestion des dépenses de santé des entreprises. Fort de près de deux décennies d'expertise, AMPS propose des solutions innovantes et centrées sur les adhérents telles que PriceDynamix, ClaimInsight et Drexi, qui génèrent des économies tout en maintenant des soins de haute qualité. Leur approche personnalisée permet aux organisations de maîtriser leurs coûts de santé sans compromettre le bien-être des adhérents, faisant d'elles un partenaire de confiance pour réaliser des économies durables en matière de santé.

Description

• Maintain HIPAA/PII guidelines to ensure the confidentiality of all calls and documents • Serve as a liaison between departments, vendors and clients to ensure collaborative progress • Exhibit strong working knowledge of customer business operations • Demonstrate strategic business acumen in decisions affecting bottom line focus • Generate and deliver accurate and timely reports • Assist with troubleshooting for technical issues • Serve as a role model in demonstrating core values of customer service • Encourage continuous learning, personal development and accountability through team members • Provide timely and thorough responses to internal and external customers • Respond to member and group correspondences regarding plan/guideline or claim questions within 24 hours • Escalate difficult issues to the appropriate channels • Assist in the processing and resolution of escalated issues • Ensure team compliance with service standards • Follow trends within assigned scope and alert appropriate parties of any trends that fall outside quality parameters • Develop and execute plans to meet established goals • Provide continuous feedback to strengthen and optimize quality performance • Work cross-departmentally to improve or streamline procedures • Maintain up to date knowledge on industry trends and look for new data sources • Develop new and improve current internal processes to improve overall quality • Conduct regular performance evaluations of employees and provide ongoing feedback and coaching as necessary • Address and counsel employees on behavioral or performance problems and implement corrective action as necessary • Explain and administer company policies required for team members to perform duties successfully • Distribute and monitor departmental workloads to ensure adequate coverage while meeting quality and service levels • Oversee new and ongoing training and update training manuals • Coordinate and actively participate in departmental meetings

🎯 Exigences

• College degree or equivalent required • Degree in Medical Billing and Coding or related field preferred • Knowledge of medical terminology preferred • 7 -10 years Claims Examiner experience or equivalent required • 4 -7 years management experience required

🏖️ Avantages

• Health insurance • 401(k) matching • Paid time off • Flexible work arrangements • Professional development opportunities