Primary accountability for specific functions and results. The list of essential functions is not exhaustive and may be supplemented or changed as necessary. List by order of importance and continue on separate page if necessary.
Performs daily claim operations supervision, including but not limited to:
Monitoring various work queues (claim, document repository, and bill review system) Apply correction action, monitor and revise procedures as needed Ensure staff compliance with policies and procedures Apply continuous quality improvement activities and training / coaching to reach and maintain high standards Financial reconciliation Vendor problem escalation Technical application administration
Provides analytical and technical research oversight to assist staff with claims and/or customer services issues. Assures outstanding issues are researched and resolved to achieve customer satisfaction; assures outstanding issues are brought to closure. Oversees and participates in troubleshooting to support quality initiatives.
5. Researches, compiles and formats information into spreadsheets
6. Assures time sensitive/confidential information is processed in a timely manner to avoid fines/penalties, and comply with IRS and statutory regulations.
7. In Claims Operation Associates absence, ensures that all administrative matters are handled appropriately.
8. Performs other duties as directed by manager. Essential Skills
Specialized Knowledge Needed For Performance of Job:
- Expert day-to-day claims operations knowledge
- Strong PC Skills (Word and Excel)
- Excellent Supervisory skills – Uses quality assurance skills to increase work reliability and proficiencies. Support claim operation dept goals ensuring excellent customer service.
- Excellent Communication and interpersonal skills – Clearly conveys information and ideas through a variety of media (Verbal, Written, and Interpersonal) to individuals or groups in a manner that engages the audience and helps them understand and retain the message
- Analytical Problem solving Skills – Analyzes information, patterns, data and cause & effect using both qualitative and quantitative information to make timely judgments and recommendations.
- Workflow Management Skills – Effectively manages time and resources to ensure that work is completed efficiently.
- Promotes positive team environment; seeks out ways to continuously improve teaming.
- Takes responsibility for own self-development; recommends areas where cross-training is needed
American Sales Company - 2 years ago
NASCO, North American Sales Company was founded in 1991 by its current president Donald J Goldberg. With over 20 years experience in...