Claims Manager (LO-A)
- Employer
- Optima Health Community Care
- Location
- Norfolk, Virginia
- Salary
- Not Specified
- Posted
- Apr 26, 2017
- Closes
- Jun 27, 2017
- Ref
- 4354708144#GIJ--J2CBackfill.1
- Category
- Claims
- Job Type
- Not Specified
- Career Level
- Not Specified
Job Description:Opportunity Profile: * WHERE VIRGINIANS CARE FOR VIRGINIANS Careers in Care As a nationally recognized provider of health plan coverage and innovative wellness programs, we live our mission to improve health every day. Optima Health Community Care is our latest offering a new Medicaid option for older people and those with disabilities. Working in partnership with the Virginia Department of Medical Assistance Services we will be managing long-term services and providing support to Virginians with complex health issues. Claims Manager Claims Manager is responsible for sustaining and developing departmental policies and procedures, providing oversight to staff responsible for claims processing activities, and ensuring that the organizations service, quality, productivity, and financial standards or goals are achieved. Oversee high dollar, complex claims auditing, monitor claims interest, perform detailed claims analyses and compose correspondence and/or detailed reports. Monitor and oversee direct reports to include Team Coordinators and employees. Assist with internal and external audits by thoroughly analyzing all errors and grievances. Create new claims policies or make recommendations to existing policies in the Claims Policies and Procedures. Qualifications: * * Education: * Bachelor's Degree * Job Experience: * 3 years - Health Plan Claims Disbursement Find out more This offers you the opportunity to make a real difference in your community. Join us and be part of a team where your skills are valued and respected.