Direct the overall functions of claims processing, including claims adjudication
Provide oversight and supervision of the claims team
Respond to complaints in a prompt and professional manner
Direct and coordinate the activities of claims and data entry areas
Maintain a working knowledge of Management Information Systems
Assist in the development and implementation of departmental policies and procedures
Oversee Medicare audit preparation, submission, and response processes

Associates in business or related field required
Bachelor's degree preferred
Equivalent years of relevant work experience may be accepted in lieu of required education
Five (5) years of healthcare claims experience required
Previous financial experience in MLTC preferred
Three (3) years previous leadership experience required
Experience with Medicare coding standards (ICD-10, CPT, HCPCS) and Medicare audit processes required

Director, Claims – Preferred Experience in Medicare

Key skills