Health Claims Manager

Please go through JD, if you would like to submit your profile, Feel free to reach me on Ext 3512 Phone (209) 436 8886.

Position: Manager of Claims Health Plans (Full-Time)

Location :- Corvallis, OR 97330

Salary:- $73,000.00 to $95,000.00 Per Year with All Benefits.

Hybrid position, will be onsite in Corvallis 2-3 times a week or more if needed. We need a candidate with strong management experience.

JOB SUMMARY/PURPOSE

Oversees and manages the Client Claims Department. Is responsible for accurate and timely claims processing for all programs administered by Client. Provides oversight to staff and ensures that the organization's performance expectations, financial standards, and goals are achieved. Enhances department bench strength by hiring, coaching and mentoring direct reports. Responsible for the completion and success of all internal and external claims audits. Analyzes claims data and ensures compliance requirements are met.

EXPERIENCE/EDUCATION/QUALIFICATIONS

Bachelor's degree in healthcare or a related field, or equivalent direct claims experience required.

Three (3) years management experience in a health plan claims department required.

Experience or training in the following required:

Collecting, analyzing and displaying statistical reports by computerized technology.

Basic medical terminology.

Medicare and/or Medicaid experience preferred.

KNOWLEDGE/SKILLS/ABILITIES

Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.

Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.

Critical thinking Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.

Communication and team building Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.