Claims Processing Manager jobs in Modesto, CA

Claims Processing Manager manages the administration of health insurance claims, payment processing, billing research, and responding to inquiries. Ensures timely and proper disposition of claims in accordance with coverage amounts. Being a Claims Processing Manager trains staff on organizational policies and ensures procedures are followed at all times. Provides guidance on more complex or high-value claims. Additionally, Claims Processing Manager typically requires a bachelor's degree. Typically reports to a head of a unit/department. The Claims Processing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Claims Processing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Instrument Tech Supervisor - Sterile Processing Supervisor - SPD Supervisor
  • Sterile Processing Services of America
  • Modesto, CA FULL_TIME
  • SUMMARY:

    Responsible for managing the flow of product and staff working on the production floor. Ensures that products reprocessed are done so according to written manufactures IFU’s, best practice standards and SPSA procedures and work instructions. Manage all aspects of the reprocessing areas including staffing, supplies, and production. Monitor customer requirements to ensure expectations are met, and coach staff on operational process steps.

    Duties and Responsibilities:

    • Must be a team player as measured by his/her peers.
    • Collaborates with the site leadership to manage operational activities pertaining to product quality to ensure 100% Customer lot acceptance.
    • Collaborates with the site leadership to manage operational activities pertaining to transportation and distribution to ensure 100% on time Customer soiled pick up and sterile product delivery.
    • Serves as a role model for sterile processing best practice, safety, and regulatory compliance.
    • Develops and fosters high performance quality driven work teams.
    • Oversees the staff shift assignments ensuring adequate resources for each production area.
    • Directs and oversees the SPSA Team Leads to ensure consistent workflow, staff direction and coaching, adherence to best practice standards, regulatory compliance, and quality.
    • Collaborates with site leadership to ensure compliance with OSHA & other employee safety regulations to ensure a safe working environment for staff.
    • Builds and maintains a good working relationship with internal and external customers. Responds to customer communications during the shift.
    • Collaborates with the site leadership and customer service manager to ensure products are processed according to the customer contract as well as timely response to quality and service issues.
    • Collaborates with site leadership on reviewing time keeping tasks such as OT approvals and timecard approvals using company tools such as ADP.
    • Collaborate with site leadership and Educator with training new employees and supporting educational needs of existing staff.
    • Works closely with transportation team to ensure on time product delivery and pick up of products to customers.
    • Collaborates with SPSA site leadership on scheduling and completion of strategic initiatives and company goals.
    • Assists Site leadership in maintaining adequate production supplies necessary for site operations.
    • Monitors staff productivity and adherence to time and attendance policies.
    • Collaborates with SPSA Site Maintenance Team on trouble shooting processing equipment to ensure optimal performance.
    • Collaborates with SPSA Quality team on promoting continuous quality improvement, establishment, and monitoring of KPIs (Key Performance Indicators) that reflect performance levels for the operation. • Other duties as required and/or assigned.

    Supervisory Responsibilities:

    The Shift Supervisor has direct supervision of all operational staff on the designated shift.

    Travel Requirements:

    None

    QUALIFICATIONS:

    Experience:

    Minimum of 3 years of production floor experience is required. 2-3 years supervisor experience with progressively increasing responsibility in a sophisticated, industry- leading manufacturing or process-oriented operation. Healthcare industry or medical device experience is preferred. Previous customer facing experience is preferred.

    Education:

    College degree is preferred. Equivalent work experience may be substituted for educational background. High School diploma or GED required.

    Certification in sterile processing (CRCST) from HSPA is required. Certification in healthcare leadership is preferred.

    Knowledge, Skills, Abilities:

    • Excellent working knowledge of MS Word, MS Excel.
    • Knowledge of management operating systems used on the product floor.
    • Knowledge of general instruments.
    • Ability to work independently, manage time and work effectively under pressure.
    • Detail-oriented, excellent organizational and documentation skills.
    • Good interpersonal and telephone skills.
    • Ability to set priorities, be flexible, multi-task and meet deadlines.
    • Ability to communicate effectively in both oral and written forms.
    • Ability to interact effectively with all levels of management.
    • Capable of communicating and coordinating with multiple departments, team player.

    PHYSICAL DEMANDS AND WORK ENVIRONMENT

    Working Conditions:

    Work is performed in a fast-paced indoor production area with little exposure to dust and high temperatures; moderate exposure to excessive noise; climate-controlled environment; and controlled access. Frequent exposure to bio-hazardous materials and strong odorous chemicals or elements.

    SPSA is an Equal Opportunity Employer

    Job Type: Full-time

    Pay: $75,000.00 - $90,000.00 per year

    Benefits:

    • 401(k)
    • Dental insurance
    • Flexible spending account
    • Health insurance
    • Life insurance
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Evening shift
    • Monday to Friday
    • Weekends as needed

    Experience:

    • Leadership: 2 years (Required)
    • Sterile Processing: 2 years (Required)

    License/Certification:

    • CRCST (Required)

    Shift availability:

    • Night Shift (Required)

    Ability to Commute:

    • Modesto, CA 95350 (Required)

    Ability to Relocate:

    • Modesto, CA 95350: Relocate before starting work (Required)

    Work Location: In person

  • 1 Day Ago

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Class C Driver - Morning Shift
  • Sterile Processing Services of America
  • Modesto, CA FULL_TIME
  • Transports product or provides services to hospital clients, potentially unloads inventory to shelves, maintains accurate counts of inventory, obtains signatures on any required documents, and interac...
  • Just Posted

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Freight Processing Lead
  • Big Lots
  • Merced, CA FULL_TIME
  • Description When you join our team, you’ll enjoy extra savings with a 20% discount on almost everything in store – even food! And a 30% discount on Indoor and Outdoor furniture. Additional benefits in...
  • 26 Days Ago

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Almond Processing Operator
  • Associated Feed & Supply
  • Denair, CA FULL_TIME
  • Job Title: Almond Processing OperatorDepartment: OperationsReports to: ManagerCompany: Associated Hulling & Shelling, LPLocation: Hulling - Saylor Rd, Denair, CAEmployment Category: Full TimeFLSA Stat...
  • 1 Month Ago

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Medical Claims Biller I
  • Riggs Ambulance Service
  • Merced, CA FULL_TIME
  • JOB TITLE: MEDICAL CLAIMS BILLER REPORTS TO: BILLING OFFICE LEAD/BILLING OFFICE DIRECTOR Rate of pay/Salary : 33,280.00 annual salary/ DOE BASIC FUNCTION: Performs a variety of functions within the bi...
  • 12 Days Ago

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Claims Administrative Support Specialist
  • Progressive Insurance
  • Modesto, CA FULL_TIME
  • As a claims administrative support specialist, you’ll play a vital role supporting our claims branch offices. In addition to ensuring essential administrative functions run smoothly, you may also inte...
  • 6 Days Ago

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0 Claims Processing Manager jobs found in Modesto, CA area

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Capital Projects Manager - Transit Focused
  • Pennino Management Group
  • Modesto, CA
  • Job Description Job Description Description: Assists Principals and Senior Project Managers with delivery of multiple pr...
  • 4/18/2024 12:00:00 AM

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Director of Information Management
  • Hedy Holmes Staffing Services
  • Oakdale, CA
  • Position: Director of Information Solutions Salary: $170,000 - $180,000 /salary (In person only) Location: Oakdale, CA S...
  • 4/18/2024 12:00:00 AM

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Chief Financial Officer
  • Community Hospice
  • Modesto, CA
  • Job Description Job Description At Community Hospice & Health Services you will find a family-based and compassionate wo...
  • 4/18/2024 12:00:00 AM

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Director of Information Management
  • Hedy Holmes Staffing Services
  • Oakdale, CA
  • Position: Director of Information Solutions Salary: $170,000 - $180,000 /salary (In person only) Location: Oakdale, CA S...
  • 4/16/2024 12:00:00 AM

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General Manager Operations - Large CPG Company - New Facility
  • aerīz
  • Riverbank, CA
  • Aeriz Holdings Corp., a multi-state, award-winning leader in the cannabis industry, is hiring a General Manager in River...
  • 4/16/2024 12:00:00 AM

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General Manager Operations - Large CPG Company - New Facility
  • Aeriz
  • Riverbank, CA
  • Aeriz Holdings Corp., a multi-state, award-winning leader in the cannabis industry, is hiring a General Manager in River...
  • 4/16/2024 12:00:00 AM

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Site Manager - Wastewater Treatment Operations
  • 360 Talent Avenue
  • Modesto, CA
  • Bring your skills into the future with a career in renewable energy. 360 Talent Avenue has partnered with an innovative ...
  • 4/16/2024 12:00:00 AM

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Performance and Quality Coordinator
  • Hedy Holmes Staffing Services
  • Modesto, CA
  • Job Description Job Description Position: Performance and Quality Coordinator Pay Rate: $23.00 /hourly Location: Modesto...
  • 4/15/2024 12:00:00 AM

Modesto /məˈdɛstoʊ/ (Spanish for "modest"), officially the City of Modesto, is the county seat and largest city of Stanislaus County, California, United States. With a population of approximately 201,165 at the 2010 census, it is the 18th largest city in the state of California and forms part of the Modesto–Merced combined statistical area. The Modesto Census County Division, which includes the cities of Ceres and Riverbank, had a population of 312,842 as of 2010[update]. Modesto is located in the Central Valley, 90 miles (140 km) north of Fresno, 40 miles (64 km) north of Merced, California, ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Manager jobs
$101,060 to $130,526
Modesto, California area prices
were up 2.5% from a year ago

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These claims management platforms are often not well integrated with peripheral systems, which also results in more human involvement and an increased cost per transaction.
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Claims Processing Manager in Topeka, KS
The claims have to be handled timely to ensure quick settlement leading to customer satisfaction.
January 12, 2020
Managers can review workflow queues and see what is in each processor’s queue.
January 13, 2020
Claims Processing Manager in Youngstown, OH
A common duty in this position is reviewing insurance policies after clients have submitted claims, in order to determine coverage.
December 11, 2019