CLAIMS MANAGER

Job Summary: This position reports to the Director of Operations and is responsible for the managing claims for Commercial, ASO and Medicare products. Provide training to staff in accordance with contracts, rules, regulations, company policies and procedures. Oversees and coordinates interaction with various health plan departments. Coordinates production of all health plan products ensuring that all claims are paid in a timely manner. Responsible for resolving questions regarding claim payments and benefits.

Qualifications and Requirements:

• Bachelor’s Degree or equivalent experience
• Five (5) years minimum experience in a health plan environment.
• Five (5) years minimum experience in Medicare/Medicaid claims processing.
• At least two (2) years previous supervisory experience.
• Minimum two (2) years’ experience in advanced computer systems
• Ability to effectively communicate in English, both verbally and in writing.
• Excellent Skills in Microsoft Excel, Word and Access.
• Ability to plan, organizes, and maintains priorities and schedules, as well as assured that deadlines are met.
• Excellent verbal and written communication skills, organizational skills, ability to interpret and apply established policy and procedure for all Health Plans products.
• Excellent human relation skills in interpersonal contracts, high personal motivation and ability to work independently, high professional judgment and behavior.
• Evidence of team collaboration, creativity, integrity, self-confident and have a commitment to quality service.
• Ability to maintain confidentiality.
• Interpersonal skills necessary to deal with a diverse group of individuals as well as establish strong cooperative working relationships.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries.  We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

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