Post Date: 7/17/2008

Ref ID: Trisha Blair
Division: Administrative

Job Title: Claims Manager
Location: Melville, NY,
Job Term: Permanent - Full Time
Salary: $55-$65K/yr

Requirements:
Bachelor’s degree or equivalent work experience. Minimum of three years leadership experience in an automated healthcare claims environment. Excellent interpersonal and leadership skills Ability to coach and deliver feedback in a balanced, professional tone Coaches both staff and peers to achieve a higher level of responsibility and outcome. Motivating Others, Dealing with Ambiguity, Organizing, Integrity & Trust, Conflict Management, Process Management, Problem Solving and Managing/Measuring Work.

Job Description:
Manages workflow, assigns claim queues (pends/adjustments), special projects, correspondence, claim in-boxes, etc. of examiners including those on-site, Telecommuters and at our vendor.. Coordinates activities with other claims management, including all claim processing sites, as needed, to balance queue assignments to ensure pend/claim production within mandated time frames. Maintains unit staffing and is responsible for the development of staff. Provides bi-weekly feedback and coaches on quality/production performance. Delivers employee performance assessments. Monitors system utilization/availability, scheduling and production of staff to ensure all performance standards are maintained and inventory is processed timely. Completes management information reports on status, production and quality. Escalates issues requiring higher-level management review. Identifies and initiates process improvements for claim accuracy and cycle time. Implements policies and procedures, as necessary. Works closely with other departments- i.e. training, quality assurance, to implement system and other operational enhancements to company processes. Serves as a liaison to customer service, sales, provider relations, etc to efficiently work “priority” items as needed. Special projects as assigned by management.. Serves as back-up to the Assistant Director, Claims Department. Performs high dollar or other special claims reviews. Please fax or email resume to: Trisha Blair Direct Hire Recruiter Staffing Remedies email: tblair@staffingremedies.com 295 Madison Avenue, 8th Floor New York, NY 10017 (p)212-683-0680/800-383-9065 (f)212-697-3007

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