Claims Processing Manager jobs in Richland, WA

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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EEOICPA Claims Processing and Verification Specialist
  • ProSidian Consulting, LLC
  • Richland, WA FULL_TIME
  • Company Description

    ProSidian is looking for “Great People Who Lead” at all levels in the organization.  Are you a talented professional ready to deliver real value to clients in a fast-paced, challenging environment?  ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value.

    ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management.  We help clients improve their operations.   

    Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers.  Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information.

    Job Description

    ProSidian Seeks a EEOICPA Claims Processing and Verification Specialist located in The Hanford Tri-Cities Area (Kennewick | Pasco | Richland) to support an engagement for the US Dept. of Energy (DOE) Hanford in Eastern Washington (Tri-Cities - Kennewick | Pasco | Richland) Area. 

    The ProSidian Engagement Team Members work to provide General Support Services Contractor (GSSC) assistance to support DOE Hanford [which consists of Richland Operations Office (RL), and Office of River Protection (ORP)] in support of the Govt’s operations, personnel management, and general administration of regional operations at the Hanford Site in Richland, Washington. 

    EEOICPA OP AB Support Candidates shall work to support requirements as a EEOICPA Claims Processing and Verification Specialist and support to the Energy Employees Occupational Illness Compensation Program (EEOICPA) Program Mgr.  across the U.S. Dept.  of Energy (DOE), Richland Operations Office (RL), Assistant Mgr.  for Mission Support (AMMS), Site Stewardship Division (SSD). EEOICPA Claims Processing and Verification Specialist shall provide staff to effectively support the EEOICPA Program Mgr.  in all phases of program implementation, including but not limited to managing all incoming and outgoing EEOICPA claims, preparing verifications of employment, and providing support for data capture requests from the National Institute of Occupational Safety and Health (NIOSH), Dept.  of Labor (DOL) and other involved parties.

    DELIVERABLES

    The EEOICPA Claims Processing and Verification Specialist shall provide support to the DOE-RL EEOICPA Program Mgr. . Such support shall include limited support to the DOE EEOICPA Program Mgr. , as requested, in support of the completion of DOE's requirements to support DOL and NIOSH during on-site data capture visits and in preparation for the data capture visits.  The ProSidian Engagement Team may be required to escort visitors to classified meetings, assist in documenting data captures, and providing other various administrative or basic technical support during these data capture visits, as directed by the EEOICPA Program Mgr.

    Other direct support by definitive work category shall include:

    • Have the ability to review and analyze personnel records for relevant information, as well as skills at preparing summary documents, as requested.
    • After receipt of the information from others on site, ,EEOICPA Claims Processing and Verification Specialist shall compile the entire package including the employment verification prepared, evaluate it for completeness and process the claim to the requesting agents.
    • Ensure that these duties are performed in a competent, professional manner that meets established milestones and delivery schedules.
    • Work products are expected to be thorough, accurate, appropriately documented, and comply with mandated schedules.
    • Contacts with claimants or other EEOICPA related staff are expected to be of the highest competence and professionalism, recognizing the personal dynamics and issues of the claimants and other impacted personnel.

    CLAIMS PROCESSING

    • Provide support on the day-to-day administration, management and tracking of all aspects of the EEOICPA claim process applicable to the Hanford and PNNL facilities and Hanford and PNNL employees.
    • Process all requests in a timely manner, as is within their scope of work and control.
    • Prepare reports, correspondence, copying, computer input, documentation as requested.
    • Communicate effectively with all Federal and contractor staff, as well as with all claimants that are in contact with the office.
    • Keep DOE-RL Program Mgr.  informed of work progress, new issues, concerns, or other items as appropriate.
    • Shipments and electronic downloads/uploads of claim related information shall be in accordance with the DOE-RL EEOICPA Program Mgr. ' s and DOE-HQ direction, policies and procedures
    • Provide routine monthly status reports and other reports as requested by the DOE-RL Program Mgr. . .
    • Conduct research to respond to inquiries from DOL and NIOSH relating to Hanford past practices or history to support claim development. These requests for research will be sporadic but require some specialized knowledge of Hanford's past contractor history.
    • Compile finding aids, as available, that document unusual sources of employment information, including historical lists of Hanford’s contractors.  Manage that information collection in a secure and appropriate manner.

    VERIFICATION OF EMPLOYMENT SUPPORT

    • Provide verification of employment reports on employees for former contractors, based on review and analysis of personnel records available. These verifications should include a narrative of the job title and work location, as well completion of the EE-5 forms required by Dept.  of Labor.

    TECHNICIAN SUPPORT

    • Assist in logging documents/boxes into an established tracking system.
    • Move records boxes from one location in a work area to another to ensure the boxes are accurately staged for various work processes.
    • The ProSidian Engagement Team employee will scan personnel, medical or claim records from paper and electronic format and merge and consolidate the scanned files e-claim files.
    • The .contractor employee will provide typing, scanning, or records management support to EEOICPA claim and other EEOICPA related functions.
    • Create documents, lists or indices from various sources.

    Qualifications

    The EEOICPA Claims Processing and Verification Specialist shall have consecutive employment in a position with comparable responsibilities within the past five (5) years, Must be able to use a computer to communicate via email; and proficient in Microsoft Office Products (Word/Excel/Power point) and related tools and technology required for the position.

    QUALIFICATIONS REQUIREMENTS

    • Depending on specific task assignments, certain permanent employees must have the ability to obtain a “Q” Clearance.
    • High school diploma required;
    • 6 years of relevant experience; and,
    • Contractor must be a U.S. citizen. ​​​​​

    TRAVEL:  Travel, both offsite and local onsite travel on the Hanford Site as coordinated with the EEOICPA Program Mgr.  and Contracting Officer is allowed, in accordance with the Federal Travel Regulations, on an as needed basis. Local travel on the Hanford Site is expected to facilitate the transfer of claim related or data capture related information.

    LOCATION:  Work shall be conducted at the Dept.  of Energy - Richland Operations Office located in Richland, WA.

    Additional Information

    As a condition of employment, all employees are required to fulfill all requirements of the roles for which they are employed; establish, manage, pursue, and fulfill annual goals and objectives with at least three (3) Goals for each of the firms Eight Prosidian Global Competencies [1 - Personal Effectiveness | 2 - Continuous Learning | 3 - Leadership | 4 - Client Service | 5 - Business Management | 6 - Business Development | 7 - Technical Expertise | 8 - Innovation & Knowledge Sharing (Thought Leadership)]; and to support all business development and other efforts on behalf of ProSidian Consulting.  

    CORE COMPETENCIES

    • Teamwork – ability to foster teamwork collaboratively as a participant, and effectively as a team leader
    • Leadership – ability to guide and lead colleagues on projects and initiatives
    • Business Acumen – understanding and insight into how organizations perform, including business processes, data, systems, and people
    • Communication – ability to effectively communicate to stakeholders of all levels orally and in writing
    • Motivation – persistent in pursuit of quality and optimal client and company solutions
    • Agility – ability to quickly understand and transition between different projects, concepts, initiatives, or work streams
    • Judgment – exercises prudence and insight in decision-making process while mindful of other stakeholders and long-term ramifications
    • Organization – ability to manage projects and activity, and prioritize tasks

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    OTHER REQUIREMENTS

    • Business Tools –  understanding and proficiency with business tools and technology, including Microsoft Office. The ideal candidate is advanced with Excel, Access, Outlook, PowerPoint and Word, and proficient with Adobe Acrobat, data analytic tools, and Visio with the ability to quickly learn other tools as necessary.
    • Business Tools – understanding and proficiency with business tools and technology, including Microsoft Office. The ideal candidate is advanced with Excel, Access, Outlook, PowerPoint and Word, and proficient with Adobe Acrobat, data analytic tools, and Visio with the ability to quickly learn other tools as necessary.
    • Commitment - to work with smart, interesting people with diverse backgrounds to solve the biggest challenges across private, public and social sectors
    • Curiosity – the ideal candidate exhibits an inquisitive nature and the ability to question the status quo among a community of people they enjoy and teams that work well together
    • Humility – exhibits grace in success and failure while doing meaningful work where skills have impact and make a difference
    • Willingness - to constantly learn, share, and grow and to view the world as their classroom

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    BENEFITS AND HIGHLIGHTS

    ProSidian Employee Benefits and Highlights: Your good health and well-being are important to ProSidian Consulting. At ProSidian, we invest in our employees to help them stay healthy and achieve work-life balance. That’s why we are also pleased to offer the Employee Benefits Program, designed to promote your health and personal welfare. Our growing list of benefits currently include the following for Full Time Employees:

    • Competitive Compensation: Pay range begins in the competitive ranges with Group Health Benefits, Pre-tax Employee Benefits, and Performance Incentives. For medical and dental benefits, the Company contributes a fixed dollar amount each month towards the plan you elect. Contributions are deducted on a Pre-tax basis.
    • Group Medical Health Insurance Benefits: ProSidian partners with BC/BS, to offer a range of medical plans, including high-deductible health plans or PPOs. ||| Group Dental Health Insurance Benefits: ProSidian dental carriers - Delta, Aetna, Guardian, and MetLife.
    • Group Vision Health Insurance Benefits:ProSidian offers high/low vision plans through 2 carriers: Aetna and VSP.
    • 401(k) Retirement Savings Plan: 401(k) Retirement Savings Plans help you save for your retirement for eligible employees. A range of investment options are available with a personal financial planner to assist you. The Plan is a pre-tax Safe Harbor 401(k) Retirement Savings Plan with a company match.
    • Vacation and Paid Time-Off (PTO) Benefits: Eligible employees use PTO for vacation, a doctor’s appointment, or any number of events in your life. Currently these benefits include Vacation/Sick days – 2 weeks/3 days | Holidays - 10 ProSidian and Government Days are given.
    • Pre-Tax Payment Programs: Pre-Tax Payment Programs currently exist in the form of a Premium Only Plan (POP). These Plans offer a full Flexible Spending Account (FSA) Plan and a tax benefit for eligible employees.
    • Purchasing Discounts & Savings Plans: We want you to achieve financial success. We offer a Purchasing Discounts & Savings Plan through The Corporate Perks Benefit Program. This provides special discounts for eligible employees on products and services you buy on a daily basis.
    • Security Clearance: Due to the nature of our consulting engagements there are Security Clearance requirements for Engagement Teams handling sensitive Engagements in the Federal Marketplace. A Security Clearance is a valued asset in your professional portfolio and adds to your credentials.
    • ProSidian Employee & Contractor Referral Bonus Program: ProSidian Consulting will pay up to 5k for all referrals employed for 90 days for candidates submitted through our Referral Program.
    • Performance Incentives: Due to the nature of our consulting engagements there are performance incentives associated with each new client that each employee works to pursue and support.
    • Flexible Spending Account: FSAs  help you pay for eligible out-of-pocket health care and dependent day care expenses on a pre-tax basis. You determine your projected expenses for the Plan Year and then elect to set aside a portion of each paycheck into your FSA.
    • Supplemental Life/Accidental Death and Dismemberment Insurance: If you want extra protection for yourself and your eligible dependents, you have the option to elect supplemental life insurance. D&D covers death or dismemberment from an accident only.
    • Short- and Long-Term Disability Insurance: Disability insurance plans are designed to provide income protection while you recover from a disability.

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    ADDITIONAL INFORMATION - See Below Instructions On The Best Way To Apply

    ProSidian Consulting is an equal opportunity employer and considers qualified applicants for employment without regard to race, color, creed, religion, national origin, sex, sexual orientation, gender identity and expression, age, disability, or Vietnam era, or other eligible veteran status, or any other protected factor. All your information will be kept confidential according to EEO guidelines.

    ProSidian Consulting has made a pledge to the Hiring Our Heroes Program of the U.S. Chamber of Commerce Foundation and the “I Hire Military” Initiative of The North Carolina Military Business Center (NCMBC) for the State of North Carolina. All applicants are encouraged to apply regardless of Veteran Status.

    Furthermore, we believe in "HONOR ABOVE ALL"  - be successful while doing things the right way. The pride comes out of the challenge; the reward is excellence in the work.

    FOR EASY APPLICATION USE OUR CAREER SITE LOCATED ON http://www.ProSidian.com/ OR SEND YOUR RESUME’S, BIOS, AND SALARY EXPECTATION / RATES TO CAREERS @ PROSIDIAN.COM.

    ONLY CANDIDATES WITH REQUIRED CRITERIA ARE CONSIDERED.

    Be sure to place the job reference code in the subject line of your email.  Be sure to include your name, address, telephone number, total compensation package, employment history, and educational credentials.

  • 7 Days Ago

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Lead Butcher
  • Lone Crow Meat Processing
  • Connell, WA FULL_TIME
  • ```Duties:``` - Prepare and cut meat products according to customer specifications - Ensure proper handling, storage, and rotation of meat products - Maintain cleanliness and sanitation standards in t...
  • 21 Days Ago

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Processing Supervisor
  • FruitSmart Inc
  • Grandview, WA FULL_TIME
  • GENERAL DESCRIPTION Oversees all shift juice processing operation; includes two lines servicing presses and decanters. This position reports to the Production Manager. This person is responsible to wo...
  • 23 Days Ago

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Sterile processing
  • Concentric Healthcare Staffing
  • Richland, WA FULL_TIME
  • Concentric is a premier staffing firm dedicated to matching outstanding talent with exceptional opportunities. Our commitment to excellence and our consultative approach has helped us become a premier...
  • 29 Days Ago

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Sterile Processing Technician
  • Providence
  • Richland, WA FULL_TIME
  • Description Under the direction of the Manager, Sterile Processing, performs a variety of tasks related to cleaning, sterilizing and assembling and wrapping surgical instruments; picks case carts; res...
  • 8 Days Ago

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Sterile Processing Technician
  • Kadlec Regional Medical Center
  • Richland, WA FULL_TIME
  • Description Under the direction of the Manager, Sterile Processing, performs a variety of tasks related to cleaning, sterilizing and assembling and wrapping surgical instruments; picks case carts; res...
  • 1 Month Ago

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0 Claims Processing Manager jobs found in Richland, WA area

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Project Coordinator (7536)
  • ACS Professional Staffing
  • Richland, WA
  • Overview: ACS Professional Staffing is looking for an employee to work on-site with our client. This Project Coordinator...
  • 4/24/2024 12:00:00 AM

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Project Manager
  • Fowler General Construction, Inc.
  • Richland, WA
  • ***NO RECRUITERS PLEASE*** Fowler General Construction is seeking qualified and experienced Project Manager professional...
  • 4/24/2024 12:00:00 AM

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Project Manager
  • Amentum
  • Richland, WA
  • Title Project Manager Position Number 38939 Company WA River Protection Solutions City/State Richland, WA Location 2435S...
  • 4/24/2024 12:00:00 AM

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Operations Programs Manager
  • Amentum
  • Richland, WA
  • Reporting to the Operations Programs and Compliance Manager, the Operations Programs Manager provides management-level d...
  • 4/24/2024 12:00:00 AM

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Operational Technology Cyber Engineering Group Supervisor
  • Bechtel Corporation
  • Richland, WA
  • # Requisition ID: _275275_ + **Relocation Authorized:** **National - Family** + **Telework Type: Full-Time Office/Projec...
  • 4/24/2024 12:00:00 AM

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Project Manager
  • Christensen, Inc.
  • Richland, WA
  • Job Details Job Location Richland Office 071,024-00 - Richland, WA Salary Range $65,000.00 - $100,000.00 Salary Descript...
  • 4/23/2024 12:00:00 AM

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Project Manager (7620)
  • ACS Professional Staffing
  • Richland, WA
  • Overview: ACS Professional Staffing is looking for an employee to work on-site with our client. This Project Manager I p...
  • 4/22/2024 12:00:00 AM

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Operational Technology Cyber Engineering Group Supervisor
  • Bechtel
  • Richland, WA
  • Requisition ID: 275275 Relocation Authorized: National - Family Telework Type: Full-Time Office/Project Work Location: R...
  • 4/21/2024 12:00:00 AM

Richland (/ˈrɪtʃlənd/) is a city in Benton County in the southeastern part of the State of Washington, at the confluence of the Yakima and the Columbia Rivers. As of the 2010 census, the city's population was 48,058. July 1, 2017, estimates from the Census Bureau put the city's population at 56,243. Along with the nearby cities of Pasco and Kennewick, Richland is one of the Tri-Cities, and is home to the Hanford nuclear site. Richland is located at 46°16′47″N 119°16′53″W / 46.27972°N 119.28139°W / 46.27972; -119.28139 (46.279657, -119.281377). According to the United States Census Bureau, t...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Manager jobs
$100,111 to $129,299
Richland, Washington area prices
were up 2.9% from a year ago

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