| Claims Processing Manager - Healthcare Job Description |
 |
| The following is a full job description for Claims Processing Manager - Healthcare. Here are the requirements and responsibilities for Claims Processing Manager - Healthcare along with statistics. If after reading this page you determine that Claims Processing Manager - Healthcare is not the position you are looking for, you may want to try one of these similar titles: Claims Processing Manager - Healthcare, Claims Processing Supervisor - Healthcare, Claims Processing Director - Healthcare, Claims Processing Clerk I - Healthcare, Claims Processing Clerk III - Healthcare, Claims Processing Clerk II - Healthcare, Claims Manager, Claims Manager, Senior, Claims Clerk IV, Loan Processing Manager |
|
| Requirements and Responsibilities For Claims Processing Manager - Healthcare |
| Manages healthcare claims processing operations to ensure accurate, timely, and compliant adjudication and payment of medical claims. Develops and monitors procedures, controls, and performance metrics to ensure accuracy and compliance. Reviews complex or escalated claims and provides technical guidance to processing staff. Monitors turnaround times, error rates, and backlog levels to meet departmental goals. Ensures compliance with regulatory guidelines, payer requirements, and company procedures. Requires a bachelor's degree. Typically reports to a director. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. |
| |
|
| Also referred to as: Healthcare Claims Operations Manager, Medical Claims Operations Manager |
|
| Similar Jobs: Claims Processing Manager - Healthcare, Claims Processing Supervisor - Healthcare, Claims Processing Director - Healthcare, Claims Processing Clerk I - Healthcare, Claims Processing Clerk III - Healthcare, Claims Processing Clerk II - Healthcare, Claims Manager, Claims Manager, Senior, Claims Clerk IV, Loan Processing Manager |
|
| Level of Education: Claims Processing Manager - Healthcare Salaries with No Diploma, Claims Processing Manager - Healthcare Salaries with a High School Diploma or Technical Certificate, Claims Processing Manager - Healthcare Salaries with an Associate's Degree, Claims Processing Manager - Healthcare Salaries with a Bachelor's Degree, Claims Processing Manager - Healthcare Salaries with a Master's Degree or MBA, Claims Processing Manager - Healthcare Salaries with a JD, MD, PhD or Equivalent |
|
|
| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
