Oversight of TriWest's claims subcontractor performance. Responsible for directing the review of current and future integration between the TriWest systems, to include TriWest medical management and web systems, which interface with the subcontractor's claims processing system. This position is also responsible for proactively and retroactively reviewing systems and claims. for accuracy and efficiency. Leadership of and participation on multidisciplinary teams. Reviews and writes changes to promote error free claims processing.
Education & Experience
o Bachelor's degree in Business, Health Care Administration or related fieldo 7 years experience with health care claims experience. o 5+ years of Supervisory experience/or project managemento Experience with business process and design analysiso Experience with data management, statistical analysis, report design and presentation
o Experience with government health care claimso Skill with data queries o HIPAA Compliance Knowledge• Knowledge of Medicare Claims processing guidelines• Claims coding experience