Responsibilities This position reports to the Director of Operations and is responsible for the managing claims for Commercial, ASO and Medicare products. Provide training to staff in accordance with contracts, rules, regulations, company policies and procedures. Oversees and coordinates interaction with various health plan departments. Coordinates production of all health plan products ensuring that all claims are paid in a timely manner. Responsible for resolving questions regarding claim payments and benefits.
Benefit Highlights:- Loan Forgiveness Program
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
- Career development opportunities within UHS and its 300+ Subsidiaries! • More information is available on our Benefits Guest Website: benefits.uhsguest.com
Qualifications Qualifications and Requirements: • Bachelor's Degree or equivalent experience
• Five (5) years minimum experience in a health plan environment.
• Five (5) years minimum experience in Medicare/Medicaid claims processing.
• At least two (2) years previous supervisory experience.
• Minimum two (2) years' experience in advanced computer systems
• Ability to effectively communicate in English, both verbally and in writing.
• Excellent Skills in Microsoft Excel, Word and Access.
• Ability to plan, organizes, and maintains priorities and schedules, as well as assured that deadlines are met.
• Excellent verbal and written communication skills, organizational skills, ability to interpret and apply established policy and procedure for all Health Plans products.
• Excellent human relation skills in interpersonal contracts, high personal motivation and ability to work independently, high professional judgment and behavior.
• Evidence of team collaboration, creativity, integrity, self-confident and have a commitment to quality service.
• Ability to maintain confidentiality.
• Interpersonal skills necessary to deal with a diverse group of individuals as well as establish strong cooperative working relationships.
• Ability to identify trends, potential problems and recommend corrective action and/or program/procedural development.
