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Claims Manager

🕒 May 22

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Logo of amps

amps

201 - 500 employees

Founded 2005

⚕ Healthcare Insurance

💳 Fintech

đŸ€ B2B

Healthcare Insurance ‱ Fintech ‱ B2B

AMPS is a leader in healthcare cost reduction for self-funded organizations, dedicated to transforming how businesses manage their healthcare spend. With nearly two decades of expertise, AMPS delivers innovative, member-centric solutions such as PriceDynamix, ClaimInsight, and Drexi that drive savings while maintaining high-quality care. Their personalized approach empowers organizations to take control of their healthcare costs without compromising member well-being, making them a trusted partner in achieving sustainable healthcare savings.

📋 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

🎯 Requirements

‱ 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

đŸ–ïž Benefits

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

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