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    Claims Operations Director - Dallas, United States - ASSOCIATION HEALTH CARE MANAGEMENT

    ASSOCIATION HEALTH CARE MANAGEMENT
    ASSOCIATION HEALTH CARE MANAGEMENT Dallas, United States

    3 weeks ago

    Default job background
    Description
    Job DescriptionJob Description

    Association Health Care Management is seeking an experienced Claims Operations Director in Adjudicating Claims to join our team in Dallas, TX

    Competitive Pay & Benefits

    MUST have TPA experience

    A Great Company Culture & Team Atmosphere That is Alive and Unique

    Please submit your application via Indeed for immediate consideration.

    We Offer

    401(k)

    401(k) matching

    Dental insurance

    Health insurance

    Life insurance

    Paid time off

    Paid training

    Vision insurance

    1 hour lunch break


    PTO
    Great Company Culture

    Bi-Weekly Incentives

    Career Mobility

    Duties & Responsibilities

    Direct the Claims team to include selection,

    training/development,

    coaching, counseling, and performance management

    Establish and successfully communicate Claims department goals and objectives together with managers and supervisors set goals and expectations; perform associate evaluations and provide coaching as appropriate

    Implement processes to ensure timely and accurate processing of claims

    Manage claims process including reconciling and auditing of claims submitted

    Provide statistical analysis of claims flow and production results

    Provide client service and technical support, including data analysis, troubleshooting, and issue resolution

    Identify and develop enhancements to the claims process, including scanning, vertexing, workflows, system software, etc.

    Develop and manage corrective action and quality improvement plans

    Ensure full compliance for all accreditations and governmental ratings

    Oversee specialty accounts management

    Special projects as assigned or necessary

    Maintain departmental documentation, internal and external certifications

    Qualifications

    Preferred Bachelor's degree in related field or equivalent combination of experience and education

    Minimum of 2 to 5 years management experience to include claims processing, managing teams, setting

    goals/expectations,

    timeline driven outcomes, and implementation of sustainable strategic solutions

    Thorough knowledge of health care insurance as might be shown by a minimum of - 5 years at an insurance company

    Proficiency in Microsoft Office

    Company DescriptionAssociation Health Care Management, Inc.

    established in 1983 has always maintained our own TPA license, giving us an advantage when dealing with complex healthcare systems.

    With this, we have helped project managers, insurance companies, benefit providers, and associations develop and implement various healthcare solutions.

    Our goal is to provide powerful healthcare management solutions in a rapidly changing industry. We help leaders solve their organization's most critical problems and opportunities. Together we create lasting change with

    significantresults. Company DescriptionAssociation Health Care Management, Inc.

    established in 1983 has always maintained our own TPA license, giving us an advantage when dealing with complex healthcare systems.

    With this, we have helped project managers, insurance companies, benefit providers, and associations develop and implement various healthcare solutions.\r\rOur goal is to provide powerful healthcare management solutions in a rapidly changing industry.

    We help leaders solve their organization's most critical problems and opportunities. Together we create lasting change with significantresults.

    #J-18808-Ljbffr
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