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)
Under the supervision of the Manager, the incumbent adjudicates claims and provides phone and/or casino onsite coverage for all member and provider interactions. Accountable for the status of claim age for all group evaluation and daily work flow. Makes adjustments daily to ensure standards are met. High school diploma or GED; one year of college level anatomy or pre-med classes or advanced medical terminology training, including ICD10 and CPT Coding; minimum two to four years’ experience in medical claims processing; word processing and data entry skills; Must have the ability to train employees and familiarity with HIPAA guidelines. Experience with Trizetto QicLink or VBA claims system preferred.
Clear All
0 Claims Processing Manager jobs found in Norwich, CT area