Job Title: Manager of Claims Health Plans
Job Summary:
The Manager of Claims Health Plans is responsible for overseeing and managing the claims process for health insurance plans. This includes handling claims submissions, resolving disputes, and ensuring that claims are processed accurately and efficiently. The Manager of Claims Health Plans plays a key role in ensuring that members receive timely and appropriate reimbursements for their healthcare expenses.
Responsibilities and Duties:
- Supervise a team of claims processors and coordinators
- Monitor and track claims submissions and payments
- Investigate and resolve any claim discrepancies or disputes
- Develop and implement policies and procedures to improve claims processing efficiency
- Collaborate with other departments to ensure seamless claims processing
- Communicate with providers and members regarding claims status and reimbursement
Qualifications and Skills:
- Bachelor's degree in healthcare administration, business, or related field
- Minimum of 5 years of experience in claims processing, preferably in a health insurance setting
- Strong analytical and problem-solving skills
- Excellent communication and interpersonal skills
- Ability to lead and motivate a team
- Knowledge of healthcare regulations and compliance requirements
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(Note: This job description is a fictional creation and is not based on any specific company or organization.)