Claims Manager
Camarillo, CA Camarillo, CA Full-time Full-time $75,000 - $105,000 a year $75,000 - $105,000 a year 10 days ago 10 days ago 10 days ago Quality Care Starts At Clinicas! This is an excellent opportunity to work for an organization that truly makes a difference in the community.
Clinicas Del Camino Real, Inc.
offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
ESSENTIAL FUNCTIONS AND
Responsibilities:
The Claims Manager is responsible for performing the following duties:
Directly manages Claims Examiners and their claim files.
Provides supervision and guidance on claim assignments, coverage analysis, establishment of and adherence to action plans in claim files, and appropriate resolution.
Work with the examiner throughout the life of the claim.
Approves action plans in accordance with best practices.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of processing claims.
Frequently communicates with all appropriate parties involved with the claim.
Works closely with other members of leadership to ensure the efficient and effective resolution of issues.
Is charged with managing pending claims, improving file quality and controlling department expenses.
Provides staff training and development.
Maintains professional vendor relationships.
Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.
Recommends staff payment and settlement authority for employees in unit.
Complies with state laws and regulations regarding claim handling.
Has a shared responsibility for department budget, which includes planning and ongoing management of salary and expenses.
EDUCATION, EXPERIENCE AND QUALIFICATIONS Bachelor's degree in business administration, public health, healthcare administration, or related field.
Minimum 5 years of claim management and leadership experience.
Ability to operate well under high-stress conditions and be extremely organized, paying high attention to detail.
Ability to mentor and motivate subordinate staff.
In-depth knowledge of appropriate legal principles.
Strong negotiation skills.
Must be articulate, communicate professionally and effectively, both verbally and in writing; accurate spelling and grammar are necessary.
Strong organizational skills, detail orientation, ability to proactively and effectively handle multiple tasks.
Proficiency with use of computers, basic programs and social media is required.
Job Type:
Full-time Pay:
$75,000.
00 - $105,000.
00 per year
Benefits:
Flexible schedule Life insurance Paid time off Vision insurance Physical setting:
Office Schedule:
8 hour shift Monday to Friday Work Location:
Hybrid remote in Camarillo, CA 93012.
Estimated Salary: $20 to $28 per hour based on qualifications.
Clinicas Del Camino Real, Inc.
offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
ESSENTIAL FUNCTIONS AND
Responsibilities:
The Claims Manager is responsible for performing the following duties:
Directly manages Claims Examiners and their claim files.
Provides supervision and guidance on claim assignments, coverage analysis, establishment of and adherence to action plans in claim files, and appropriate resolution.
Work with the examiner throughout the life of the claim.
Approves action plans in accordance with best practices.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of processing claims.
Frequently communicates with all appropriate parties involved with the claim.
Works closely with other members of leadership to ensure the efficient and effective resolution of issues.
Is charged with managing pending claims, improving file quality and controlling department expenses.
Provides staff training and development.
Maintains professional vendor relationships.
Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.
Recommends staff payment and settlement authority for employees in unit.
Complies with state laws and regulations regarding claim handling.
Has a shared responsibility for department budget, which includes planning and ongoing management of salary and expenses.
EDUCATION, EXPERIENCE AND QUALIFICATIONS Bachelor's degree in business administration, public health, healthcare administration, or related field.
Minimum 5 years of claim management and leadership experience.
Ability to operate well under high-stress conditions and be extremely organized, paying high attention to detail.
Ability to mentor and motivate subordinate staff.
In-depth knowledge of appropriate legal principles.
Strong negotiation skills.
Must be articulate, communicate professionally and effectively, both verbally and in writing; accurate spelling and grammar are necessary.
Strong organizational skills, detail orientation, ability to proactively and effectively handle multiple tasks.
Proficiency with use of computers, basic programs and social media is required.
Job Type:
Full-time Pay:
$75,000.
00 - $105,000.
00 per year
Benefits:
Flexible schedule Life insurance Paid time off Vision insurance Physical setting:
Office Schedule:
8 hour shift Monday to Friday Work Location:
Hybrid remote in Camarillo, CA 93012.
Estimated Salary: $20 to $28 per hour based on qualifications.
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