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Job Description
- Supervise and manage the medical claims processing team, ensuring accurate and timely claims
submission. - Lead and supervise various quality projects to enhance the quality of submitted claims.
- Resolve processing team issues and follow up to ensure continuous improvement.
- Collaborate with other departments to resolve any issues related to the Claims Team.
- Manage all incoming and outgoing emails to ensure the smooth flow of documents.
- Coach and train new team members on policies, procedures, and medical guidelines.
- Provide medical guidance to Claims Department staff.
- Address queries from providers and insurance companies related to acute and chronic claims.
- Lead and supervise training sessions, including team meetings and one-on-one sessions, and prepare
Job Requirements
- Bachelor’s degree in Pharmacy
- Exemption from any current governmental mandates.
- 3+ years of experience in a similar role, familiarity with medical claims processing and insurance
reimbursement procedures. - Strong interpersonal and negotiation skills.
- Ability to thrive in a fast-paced environment and manage stress effectively.
- Detail-oriented with strong organizational skills.
- Ability to work both independently and as part of a team.
- Fluency in English (written and spoken)
- Proficiency in Microsoft Office, especially Excel.