Manager - Quality

Posted 5 months agoViewed

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💎 Seniority level: Manager, 7 to 10 years

📍 Location: US

🔍 Industry: Healthcare

🗣️ Languages: English

⏳ Experience: 7 to 10 years

🪄 Skills: LeadershipProject ManagementData AnalysisPeople ManagementProject CoordinationHR ManagementCross-functional Team LeadershipOperations ManagementStrategyCommunication SkillsAnalytical SkillsCollaborationMicrosoft ExcelC (Programming language)

Requirements:

Graduate/Postgraduate in any field (preferably in Sciences).
7 to 10 years of healthcare claims quality auditing experience.
1 to 2 years of leading a team of 45+.
Thorough knowledge of medical terminology and claim processing procedures.
Experience with ICD9, ICD10, CPT coding systems is preferable.
2-3 years of prior health care processing experience in Managed Care.
Effective oral and written communication skills.

Responsibilities:

Manages and supervises the Claims Team to ensure claims are paid properly and timely.
Identifies and addresses problem areas such as understaffing and customer complaints.
Coordinates and manages projects for department development.
Analyzes work processes and makes recommendations for improvements.
Handles all personnel-related duties including counseling, interviewing, and performance reviews.
Provides timely monthly reports on claims payment and inventory.

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Manager - Quality

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