Section: Healthcare & Nursing Vacancy 1448

Post:Claims Administration Manager

Salary contractual

Requirements and conditions

Age:

Has no value

Gender

Has no value

Education:

Work schedule:

Has no value

Work place:

London

The announcement text:

At Healthfirst employees are the company and the key to our success. As Healthfirst continues to grow, we take pride in our diverse staff that believes in our mission to improve the health status of low income individuals and families by increasing access to high quality healthcare, providing great customer service, and addressing individuals` total healthcare needs. In an ever changing industry, once you become a Healthfirst employee it is our goal you continue developing your career within our team.

Healthfirst`s staff receives a competitive benefit package including:

Medical Insurance

Dental and Vision Insurance

Flexible Spending and Health Savings Accounts

Life Insurance

401(K) and Profit Sharing

Educational Assistance Program

Employee Assistance Program

Employee Fitness Program And More!

Established in 1993, Healthfirst is a hospital-sponsored organization dedicated to providing the highest possible care, access and customer service to its members. Headquartered in New York City, Healthfirst offers a variety of Medicaid, Medicare and commercial healthcare programs. Over 85 hospitals and medical centers and close to 20,000 physicians and specialists make up the Healthfirst provider network. With over 1,800 employees, the Healthfirst family of companies includes Healthfirst in New York, Healthfirst NJ in New Jersey, and HF Management Services, which provides comprehensive administrative services to healthcare organizations in New York, New Jersey, and Florida.

If you thrive in a diverse, fast paced, friendly, and quality driven environment, consider joining the Healthfirst family and improve the healthcare delivery system every day.

Established in 1993, Healthfirst is a hospital-sponsored organization dedicated to providing the highest possible care, access and customer service to its members. Headquartered in New York City, Healthfirst offers a variety of Medicaid, Medicare and commercial healthcare programs. Over 85 hospitals and medical centers and close to 20,000 physicians and specialists make up the Healthfirst provider network. With over 1,800 employees, the Healthfirst family of companies includes Healthfirst in New York, Healthfirst NJ in New Jersey, and HF Management Services, which provides comprehensive administrative services to healthcare organizations in New York, New Jersey, and Florida.

At Healthfirst, employees are the company and the key to our success. As Healthfirst continues to grow, we take pride in our diverse staff that believes in our mission to improve the health status of low income individuals and families by increasing access to high quality healthcare, providing great customer service, and addressing individuals` total healthcare needs. In an ever changing industry, once you become a Healthfirst employee it is our goal you continue developing your career within our team. If you thrive in a diverse, fast paced, friendly, and quality driven environment, consider joining the Healthfirst family and improve the healthcare delivery system every day.

Job Title: Manager, Claims Administration

Department: HF Claims

Reports To: Director, Claims

Position Summary:

The Claims Administration Manager will be responsible for overseeing the performance and resource management of 50+ examining staff handling new claims inventory, correspondence and special handling. The incumbent will oversee the workforce; performance and resource management component to ensure claims are processed accurately and timely in accordance with regulatory and corporate requirements.

Essential Duties and Responsibilities:

1. Performance Management - prepare daily work schedules and monitor performance to ensure claims are handled timely, accurately and meet established regulatory and corporate metrics. This includes managing staff`s daily Rate Per Hour (RPH) standards and overtime hours and production.

2. Workforce/Resource Management - strategize, plan, assign and direct work to both in-house and telecommuting staff. Based on inventory levels, redirect resources to meet established regulatory and corporate metrics.

3. Monitor, prepare, analyze and present daily status on examiner production and inventory to the Claims Director.

4. Communicate effectively in writing and verbally ` especially with staff working from home.

5. Address staff complaints and help resolve problems in conjunction with other operation managers and working units. Handle all personnel issues including the monitoring of attendance, punctuality and progressive disciplinary actions. This includes working, in conjunction with the Claims Director and Human Resources, on proper documentation and timely counseling of employees.

6. Develop strategies to increase examiner performance (i.e. production, quality, etc.) standards. Evaluate opportunities to improve the routing of claims in MACESS workflow system. Work with other operating units to analyze results and identify areas for process and quality improvement while providing feedback to examiners.

Other Duties and Responsibilities:

Identify the need of training and development of policy, procedures and job-aids to aid examiners on processing of all types of claims.

Must have mathematical skills with proficiency in analyzing reports and data. Must have excellent oral and written communication skills and be proficient in Microsoft Word and Excel. Must have the ability to be objective and professional when involved in conflict resolution with staff and identify and select qualified candidates to fill positions.

Knowledge and Skills Required:

Supervision Necessary: Work performed under light supervision with only occasional general supervisory review.

Independent Action: Sets goals and priorities for functional area. May make recommendations for department policies, practices and

programs.

External contacts/"Customer" Service: Contact with external `customers`/contacts to furnish or obtain factual information.

Internal Contacts: Internal contact outside own department/group to persuade, gain cooperation and acceptance of ideas or collaborate on significant projects.

Decision Making: Decisions have major impact on the management and operations of an area within a department. Job may

contribute to important business decisions that impact the department.

Problem Solving: Identify the problem by collecting information form several sources, analyzing, the data and recommending an

appropriate solution.

Independent Judgment: Duties are varied in nature, requiring the solving of both commonly encounters and unusual problems. This job`s immediate supervisor is consulted for clarification of policies/procedures.

Complexity of Tasks: The types of tasks change continually and require extensive capability in office protocol.

Budget Responsibility: Has no budget responsibility

Education/Job Requirements:

` 5 years of performance/resource management experience required.

` Bachelor`s degree required.

` Successful record in supervisory and managerial experience.

` Managed a department/unit of 50+ employees.

` 3-5 years work experience in a Healthcare setting preferred.

` Knowledge of Power MHS and MACESS Doc-Flow preferred.

Technical Skills:

To perform this job successfully, an individual should have knowledge of Intermediate Microsoft Outlook and Advance Microsoft Word, Excel.

Written and Oral Communication:

Frequently communicates complex information and interacts with management. May train and monitor others` performance. Can present, resolve conflicts and address delicate situations.

Physical Demands:

While performing the duties of this job, the employee is frequently required to bend; walk; sit; key and stand. The employee must occasionally lift and/or move up to 10 pounds.

Work Environment:

While performing the duties of this Job, the employee regularly works in an indoor environment.

How to Apply:

Please visit our website at www.healthfirstny.com and apply for the Manager, Claims Administration position. The requisition # heal-00001814.

Conditions of Employment: Employee must pass pre-employment screening which includes a background check and drug testing. Employee must present documentation to verify minimum of high school educational requirement.

Disclaimer: The statements herein are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

Principals only. Recruiters, please don`t contact this job poster.

Please, no phone calls about this job!

Please do not contact job poster about other services, products or commercial interests.

Contact information

Employer:

Юридический супермаркет™

Email:

hr@rezultat.com.ua

Phone:

Publication date: 2009-11-27 17:09:06

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Section: Healthcare & Nursing Vacancy 1448

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Section: Healthcare & Nursing Vacancy 1448

Vacancies
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in London