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Centers Plan for Healthy Living (CPHL), is a Managed Care Organization servicing members with Medicare and/or Medicaid. Our goal is to provide members and all those involved in their care with the guidance and health plan choices they need for healthy living. CPHL is committed to providing quality, coordinated health care to some of the most honored and yet still vulnerable members of our community.
Responsible for managing and overseeing the overall operations of the Claims Processing unit of HEALTH PLAN in accordance with HEALTH PLAN policies, state and federal standards. Manages the day-to-day activities of the Claims Processing staff.
Competencies
Experience: Minimum three to five years’ experience in business/managed care setting, including three years in Medicare and Medicaid claims required. Minimum three years supervisory experience required. Proficiency in a claims processing system required. Proficient PC skills, including Microsoft Office Products such as Excel, Access, Word and PowerPoint required. Proficient use of Microsoft Access. Desired knowledge of creating queries using Access data bases or other SQL based products.
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