Medical Claims Manager

Medical Claims Manager COMPANY: Emblemhealth LOCATION: 34th Street

HOURS:

DEPT:

Description of Duties Posting Closing Date: 11/9/2009

* Develop, evaluate and manage supervisory staff as well as Claim approvers to provide effective claims processing while ensuring quality and production standards are met * Plan, organize and direct the operation in the processing of medical claims to ensure that production standards, quality and cycle time are maintained. * Leverage the Units resources to resolve claim problems by: analyzing claim data, identifying trends and issues, performing root cause analysis, and acts on the needs to improve the development and delivery of claim processing * Manage and monitor daily workflow and preparation of daily , weekly, monthly production and inventory reports in ensure business objectives are maintained * Implement core business processes and guide process improvement initiatives in order to enhance overall customer service. Implement processes to ensure proper handling and timely processing of medical claims * Assess individual and team performance on a regular basis and provide developmental feedback. Complete and deliver performance appraisals. Develop training plans and ensure training needs are met. Coach and counsel employees who are not meeting departmental production and quality standards. Investigate any departmental errors cited by the Internal Audit department Knowledge Skills & Abilities: * Excellent listening, written and verbal communication skills * Demonstrated ability to build successful working relationships (internally and externally) * Demonstrated management/supervisory and business administrative experience and knowledge * Ability to manage and motivate a high performing team with proven leadership ability * Ability to prioritize, follow-up and follow-through with timeliness and accuracy while remaining organized with a keen sense of detail * Time management skills and flexibility to work on multiple projects/assignments * Superior conceptualization, planning and organizational skills

Requirements  * Bachelors degree in Business Management or equivalent experience. * Three plus years supervisory experience within a related health care and/or medical claims environment required. * Must be PC literate and possess a strong understanding of Microsoft Office Suite

If you are interested and qualified, please e-mail your resume and job posting application to yhartung@ghi.com.  This job-posting announcement expires, Monday, November 9, 2009

Please refer to job code ghi-2268 when responding to this ad.

Category:	Accounting/Banking/Finance/Insurance
	> Claims
Location:	New York City, NY
County:	County
ZIP Code:
Pay Rate:	Open
Job Terms:	full time
Company:	GHI
Phone:	email only please
Fax:	email only please