Manager, Commercial Claims
Peak Health
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- Designs, builds and maintains operational processes, policies and procedures to support Claims processing
- Partners with IT and other leaders to develop business requirements to support core administration system deployment
- Recruits, trains and develops a highly engaged team of claims processors
- Claims inventory management and load balancing to meet contractual and organizational objectives
- Anticipates future demands of initiatives related to people, process and technology and works with leadership to design and implement solutions to these needs
- Collaborates with IT, Enrollment, Medical Management, Member & Provider Services and Finance to identify and implement processes to drive continuous improvement
- Continually assesses activities and processes to ensure efficiency and added value
Requirements
- Bachelor’s degree Business Administration, Health Administration or related field AND Five (5) years of progressive experience working with medical or institutional claims in a production environment
- High School Diploma or equivalent AND Nine (9) years of progressive experience working with medical or institutional claims in a production environment
- Two (2) years of experience working with Medicare and/or Medicaid claims
- Three (3) years of management experience
Benefits
- Competitive salary
- Flexible scheduling and paid time off
- Health and wellness programs
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingclaims inventory managementload balancingbusiness requirements developmentprocess designcontinuous improvementoperational processespolicies and proceduresMedicare claimsMedicaid claims
Soft Skills
team developmentleadershipcollaborationanticipation of future demandsefficiency assessmentengagementcommunication
Certifications
Bachelor’s degreeHigh School Diploma