Responsible for managing and overseeing the overall operations of the Claims Processing unit of Centers Plan for Healthy Living in accordance with Centers Plan for Healthy Living (CPHL) policies, state and federal standards. Manages the day-to-day activities of the Claims Processing staff.
Education and Experience:
Required: Bachelor's Degree in Business Administration or related field required.
Type of Experience
Required: Minimum five years’ experience in business/managed care setting, including three years in Medicare and Medicaid claims required. Minimum three years supervisory experience required.
Specific Technical Skills
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.
Preferred: Desired knowledge of creating queries using Access data bases or other SQL based products.
Knowledge and Skills:
· Effective presentation skills
· Excellent verbal and written communication skills
· Must be able to participate in meetings with all levels of management within the organization
· Detail oriented, excellent follow up
· Ability to multi-task in a fast paced environment
· Must be service oriented, quick learner, team player
· Appreciation of cultural diversity and sensitivity toward target population
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification. They should not be construed as an exhaustive list of all responsibilities, duties and skills required.