[Hiring] Claims Assistant Manager @DELTA HEALTH SYSTEMS MCC

Role Description

• Assist with the supervision of staff specific but not limited to training, planning, and directing work.
• Responds to staff, internal and external customer inquiries, and provides resolution to issues accordingly.
• First point of contact for customer calls that require research and a response.
• Manages assigned tasks, queues, and ensures inventory is handled within department guidelines.
• Manages internal emails, tracks inventory, and collaborates with staff for timely responses within department guidelines.
• Collaborate with reporting manager to ensure turn-around times, quality standards, and company goals are met.
• Trend errors for assignments, identify training needs for staff, collaborate with quality assurance on unit module updates.
• Attends staff meetings to assist with delivery of materials, trainings, and communication.
• Assists in the coordination of the work flow and control of work procedures.
• Provides guidance to subordinates regarding general claims and escalated issues.
• Communicates directly with clients, providers, and internal and external areas.
• Adherence to company and department policies and procedures.
• Understands the guidelines for timeliness and the expected turnaround time within the department.
• Must occasionally travel to client locations.
• Performs other duties as assigned.

Qualifications

• Two to four years of management and claims experience.
• Must be computer literate with proficiency in spreadsheet and word processing applications.
• Excellent written and verbal communication skills.
• Must have excellent leadership abilities and interpersonal skills; ability to establish confidence, rapport, and foster cooperative relationships with clients, providers, and co-workers.
• Must understand self-funded payer claims policies as well as Federal, State, and other regulations pertaining to health insurance claims payment including TPL, COB, and coding and reimbursement methodologies.
• Experience with automated claims systems; and ability to maintain sound production operations also required.

Requirements

• This position reports directly to a Stockton Claims Manager.
• Limited supervision with considerable responsibility for work quality and quantity.