$80000 - $100000 Year
Monday to Friday
Day shift
Health insurance
Hospital claims.
Lead Fulfillment related implementations and change requests.
Interact with customers (internal / external) and keep partners informed of project and production performance.
Maintain document asset library.
Perform document design and testing.
Collaborate with vendor, client and internal teams as needed.
Monitor vendor file receipts and their print & mail activities.
Coordinate production error handling activities as needed.
Manage and resolve issues.
Ensure adherence to quality norms and procedures.
Create status reports for both internal and external customers.
Develop and maintain policy and procedure documentation.
Ensure timely completion of tasks assigned to all team members.
Maintain confidentiality of all information, policies, and procedures as required by the Health Insurance Portability and Accountability Act (HIPAA) protocols.
Drive a culture of continuous improvement within the team.
Processing Complex claims.
Identifying gaps between external expectations and system limitations and suggests improvements or streamlined maintenance processes and techniques if applicable
Follow established processes, standards and procedures designed to minimize service level agreement violations
Analyze complex customer business requirements and software/product objectives; designs, configures, supports and maintains complex application designs to meet the customer needs
Coordinate and supervise daily/weekly/monthly activities of a team members including setting priorities for the team to ensure task completion and performance goals are met.
Lead inventory and performance to business metrics.
Maintain various MIS Reports like productivity, Quality, Inventory, error report, updates tracker etc.
Skills Required:
Ability to multi-task and organize work effectively
Conduct root cause analysis to resolve issues related to basic system configuration
Understand relationship and dependencies among contract, benefit, adjudication, claims and payment systems
Knowledge of CMS/State Guidelines and Billing Codes
Communication
Leadership
Computer
technology
Ability to multi-task and organize work effectively
Experience in Healthcare Claims and Enrollment Operations
Proficient in using Microsoft Office software
Prior leadership experience
Previous experience working with healthcare communications vendors.
Manufacturing
On going position
General Location, within a limited area