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Director, Claims Operations

CE Computech Ferguson, MO Full-Time
$90,677.00 (Careerbuilder est.) What is the Careerbuilder Estimated Salary? Only about 20% of the jobs in our search results contain salary information. When a job posting doesn’t include a salary, we estimate it by looking at similar jobs in the same industry in that location. It is not necessarily endorsed by the employer and actual compensation may vary based on your experience.
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Develop the vision and goals for the claims department in compliance with federal, state and Company guidelines
Oversee and ensure achievement and maintenance of all claims processing standards within established guidelines
Partner with multiple business units, health plans and other stakeholders to establish operational objectives and procedures.
Identify business needs and drive change initiatives to address these issues
Ensure all issues are resolved accurately and timely and implement action plans to address any issues
Identify and implement operational efficiencies and development of “best practice” policies and procedures
Analyze customer impact and respond to complex escalated customer service and claims processing issues to ensure that customer expectations are consistently met

Qualifications:

Direct the day-to-day operations of the claims department and ensure accurate and timely processing of members medical claims within established state and company compliance guidelines.

Education/Experience:

Bachelor’s degree or equivalent experience. 7+ years of operations management, financial management or analysis, or claims operations experience, preferably in a managed care and/or Medicaid setting. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff

Recommended skills

Medicaid
Performance Management
Management
Claims
Managed Care
Operations Management

Location

CareerBuilder Estimated Salary What is the Careerbuilder Estimated Salary? Only about 20% of the jobs in our search results contain salary information. When a job posting doesn’t include a salary, we estimate it by looking at similar jobs in the same industry in that location. It is not necessarily endorsed by the employer and actual compensation may vary based on your experience.

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What is the Careerbuilder Estimated Salary?

Only about 20% of the jobs in our search results contain salary information. When a job posting doesn’t include a salary, we estimate it by looking at similar jobs in the same industry in that location. It is not necessarily endorsed by the employer and actual compensation may vary based on your experience.
This estimation is based on Job title, Industry, Location and Skills
$90,677
Avg. Yearly Salary
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