Blue Signal Search
Our client is a prominent leader in the healthcare space as they are taking an innovative approach on the way health care is provided and managed. They focus on integration of system processes so that physicians can streamline their internal procedures for their patients. They are hiring a Medical Claims Manager to lead a team of claims professionals in medical coding and run post-payment audits.
The Medical Claims Manager is the SME surrounding benefits, policies, and claims. They will provide training and leadership to the claims team, supporting company goals and adhering to regulations to maintain compliance.
This Role Offers:
• Competitive base salary plus great benefits package – medical/dental/vision, etc.
• Strong culture of promotion and training.
• Tight-knit company with a small family feel; culture centered around teamwork and collaboration.
• Work alongside a team of strong healthcare professionals with emphasis on employee success and mentorship.
• Lots of career advancement paths and opportunities available to acquire new skills.
• Culture of high performance and quality customer care.
• Train, manage, coach, and delegate tasks to the claims team. Serve as SME for all things claims.
• Set goals for team metrics and individual performance and maintain benchmark records for progress. Conduct meetings to mediate any shortfalls as needed.
• Responsible for the inventory and management of insurance claims.
• Contact providers and partners regarding claims, payment options, and complete necessary steps for attaining records.
• Identify and correct compliance issues, documentation shortfalls, and areas for improvement.
• Identify improvement opportunities and recommend workable solutions supported by cost benefit analysis.
• Stay up to date on and review coding updates, documentation changes, and relevant guidelines.
• Prepare reports, statements, and analysis to assist teams in assessing risk and strategy.
• Support both internal and external audit requests as requested.
• Maintain excellent documentation for all activities.
• 3+ years of medical claims experience. Prior leadership experience a plus.
• Background in medical billing and coding, with experience maintaining production standards and managing claim inventory.
• Strong understanding of relevant compliance and claim submission standards.
• Up to date knowledge of ICD and CPT codes.
• Leadership attributes with the ability to communicate goals, create buy in, and inspire action.
• High level of professionalism and confidentiality while maintaining sensitive information.
To apply for this job please visit www.bluesignal.com.