Health Claims Manager

Health Claims & Customer Service Manager - Our client has a Direct Hire opening for a managerial position. For consideration, please email resume to jodi.ayers@activatestaffing.com

Job Description

Health Claims & Customer Service Manager needed for Health Insurance company in Beaverton, OR.

The successful candidate will be:

  • Responsible for managing the day-to-day activities of claims and customer service.
  • Ensure operations are efficient, effective and compliant.
  • Ensure contractual obligations are met, regulatory timeframes are adhered to and customers are provided a high level of service.

Responsibilities:

  • Recruit, train develop, supervise and evaluate direct reports
  • Ensure performance expectations and standards are conveyed and clearly understood by department staff.
  • Evaluate employee's performance by conducting annual performance reviews and periodic performance check-in meetings.
  • Ensure staff has the information, tools and resources necessary to perform their jobs
  • Responsible for coordination of staff and Claims Department workflows
  • Proactively monitor and ensure that the claims department operates in compliance with applicable state, federal and HIPAA requirements while meeting contracted client service agreements.

Requirements:

  • Bachelor's degree required
  • 5+ years' experience as a health plan/carrier claims or customer service manager.
  • Knowledge of state, federal and other regulations as it relates to claims and customer service administration
  • In-depth knowledge of claim adjudication principles and procedures
  • Prior experience with Medicare and Medicaid programs preferred.
  • Experience with QNXT Claims Processing system preferred.

Salary Range:

  • $80,000 - $95,000 per year

About Activate Staffing LLC

The Resource for Insurance Professionals
Activate Staffing is a premier staffing firm specializing in the Insurance Industry. Our staff is comprised of the best Insurance and Staffing professionals in the industry to fill the staffing needs of Insurance Companies, TPAs, Self-Insured Entities, and Retail and Wholesale Agencies and Brokerages. We have the breadth of knowledge and the skills needed to successfully match top-notch talent with highly rated companies. Give us a call, and Expect the Best!

Share Job

Job Summary

  • Job ID

    1896433

  • Category

    Health Claims

  • Location

    Beaverton, OR

  • Order Type

    Direct Hire

  • Contact Phone

    (720) 633-9726

Similar Jobs

  • Commercial Lines Account Manager

     1854832
     Agency/Brokerage
     Beaverton, OR
    Superior independent insurance agency in Beaverton, OR has a Direct Hire opening for a Commercial Lines Account Manager to serve on a team, dedicated ...

  • Commercial Lines Account Manager

     1899305
     Agency/Brokerage
     Portland, OR
    Commercial Lines Account Manager - Our client has been ranked in the top "100 Best Workplaces" for 9 years in a row!! They are an employee owned Insu...

  • Commercial Underwriter

     1896556
     Underwriting
     Portland, OR
    Commercial Lines Underwriter - Our client, an insurance carrier in Portland, is looking for a Commercial Underwriter to work on a Direct Hire basis. F...

  •   Search All Jobs
© 2024 People 2.0 Global, Inc.
v2024.5.01.0