Director, Claims Support

🔥 0 minutes ago

🌵 Arizona, California, +1 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🎰 Nevada – Remote

💵 $144.4k - $238.2k / year

⏰ Full Time

🔴 Lead

👔 Director

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Millennium Physician Group

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2008

👥 B2C

🧘 Wellness

B2C • Wellness

Millennium Physician Group is one of the largest physician-led healthcare provider organizations in Florida, operating more than 200 locations and over 900 clinicians. The group provides primary care, numerous medical specialties, walk-in and urgent care clinics, virtual care/telehealth services, and patient-facing tools like a patient portal and mobile app for scheduling, billing, and medical records access. Millennium focuses on coordinated, patient-centered clinical care across a broad range of specialties.

📋 Description

• Direct all aspects of claims intake, adjudication, payment, adjustment, and provider reimbursement activities. • Ensure claims are processed accurately, timely, and in compliance with contractual, regulatory, and organizational requirements. • Provide leadership and guidance on highly complex claims and provider disputes. • Establish and monitor operational metrics, SLAs, productivity standards, and quality indicators. • Lead continuous improvement initiatives focused on automation, efficiency, payment accuracy, and provider experience. • Ensure compliance with CMS, Medicare Advantage, Medicaid, and state regulations. • Lead strategic planning, budgeting, workforce planning, and operational transformation initiatives. • Partner with providers, delegated entities, vendors, and internal stakeholders to resolve issues and improve performance. • Lead, coach, and develop managers and claims professionals across multiple locations.

🎯 Requirements

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, Public Health, or related field, or equivalent experience. • Minimum 9 years of progressive healthcare claims operations experience. • Minimum 5 years of leadership experience managing managers and/or large operational teams. • Experience within Medicare Advantage, Medicaid, Managed Care, Health Plan, or Payer environments.

🏖️ Benefits

• 3 weeks PTO & 8 paid holidays • Medical, Dental, Vision • Employer Paid Basic Life & Short Term Disability coverage (goes into effect after 1 year of full-time employment) • 401(k) with match • Employee Wellness • Other Employee Discount programs like Tickets at Work and cell phone discounts • Other benefits: Dependent Care FSA, Voluntary Life, Long Term Disability, Critical Illness, Pet Insurance, and more