What You’ll Do:

• Lead the claims and customer service staff to ensure prompt and accurate settlement of claims, appeals, and/or customer service inquiries. Coordinates with other areas while establishing and maintaining excellent customer relations.

• Analyze problems and concerns to make effective decisions that provide positive solutions. Make recommendations for process improvements and efficiencies for the department.

• Manage the recruiting, hiring, coaching, and mentoring, monitoring and evaluation, and addressing all disciplinary issues in a timely manner.

• Encourage staff in creating and maintaining a work environment with high morale and employee satisfaction through support of professional development, training, career growth, and rewarding high performance. 

• Serve as a liaison for internal and external customers. Ensures the timely and accurate resolution of any issues and/or provides necessary training to staff as needed or requested.

To Qualify for This Position, You'll Need the Following:

• Required Education:

• Bachelor’s degree OR 4-years of healthcare experience in customer service, provider network service, membership, billing, and/or claims/appeals processing operations.

• Required Work Experience:

• 2-years of claims/appeals, customer service, or call center experience

• Required Skills and Abilities:

• Strong analytical, organizational, and judgment skills.

• Excellent customer service skills.

• Ability to persuade, negotiate or influence.

• Strong oral and written communication skills.

• Strong spelling, punctuation, and grammar skills.

• Demonstrated leadership ability.

• Microsoft office proficient.

We Prefer You Have the Following:

• Bachelor’s degree

• 4 years-of healthcare, customer service, or claims experience.

• Previous budget experience.   

• 1 year-of leadership experience including scheduling or coordinating work of others, developing work procedures and training for others, and/or leading group project initiatives

• Strong presentation skills.

• Basic business math skills.

• Ability to interact easily with customers, staff, and other members of the organization.

• Knowledge of the benefit plans for each group.

• Knowledge of all systems and their roles in claims adjudication.

• Strong leadership skills to direct and motivate employees.

• Knowledge of performance standards and quality assurance guidelines.

Our Comprehensive Benefits Package Includes the Following:

We offer our employees great benefits and rewards.  You will be eligible to participate in the benefits for the first of the month following 28 days of employment.  

• Subsidized health plans, dental and vision coverage

• 401k retirement savings plan with company match

• Life Insurance

• Paid Time Off (PTO)

• On-site cafeterias and fitness centers in major locations

• Education Assistance

• Service Recognition

• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers, and contribute their unique abilities to the growth of our company.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the required qualifications.