Medical Claims Manager

  • location: Metairie, LA
  • type: Contract
  • salary: $19 per hour
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job description

Medical Claims Manager

job summary:
Description:

1. Assist the A&G and Health Plan team with contacting members, providers and internal matrix partner in order to resolve Grievances.

2. Assist the Health Plan Transportation team with resolving member transportation issues.

3. Documenting issues into the Health Plan complaints tracking log located on the HP SharePoint.

4. Assist with the completion of State Monthly Reports.

5. Claims and Clinical documentation research knowledge

6. Able to work with a SharePoint, Healthcare Management Authorization systems, Claims processing systems, and other software applications (CSP Facets, Sales Force, NDB)

Must have qualifications/experience:

1. Knowledge of working in Microsoft Office (Outlook-Email, Word, PowerPoint and Excel)

2. Knowledge of operating a Copier and Fax Machine

3. Claims research and processing knowledge

4. Excellent verbal and written communication skills

5. Working with cross-function team members from Health Plan Operations, Health Services, Appeals & Grievances, Member, Provider Customer Service, Dental, Behavior Health,

Transportation Vendor, Vision, and Compliance.

6. Able to manage multiple projects across multi-functional teams.

Requirements:

- 1-2+ years of experience in healthcare management, marketing or a related field

- 1-2+ years of successful experience in managed care

- 1-2+ years knowledge of current managed care preferably Medicaid and Government Programs

Preferred Qualifications:

- Bachelor's Degree

 
location: Metairie, Louisiana
job type: Contract
work hours: 8 to 5
education: Bachelor's degree
experience: 1 Years
 
responsibilities:
Description:

1. Assist the A&G and Health Plan team with contacting members, providers and internal matrix partner in order to resolve Grievances.

2. Assist the Health Plan Transportation team with resolving member transportation issues.

3. Documenting issues into the Health Plan complaints tracking log located on the HP SharePoint.

4. Assist with the completion of State Monthly Reports.

5. Claims and Clinical documentation research knowledge

6. Able to work with a SharePoint, Healthcare Management Authorization systems, Claims processing systems, and other software applications (CSP Facets, Sales Force, NDB)

Must have qualifications/experience:

1. Knowledge of working in Microsoft Office (Outlook-Email, Word, PowerPoint and Excel)

2. Knowledge of operating a Copier and Fax Machine

3. Claims research and processing knowledge

4. Excellent verbal and written communication skills

5. Working with cross-function team members from Health Plan Operations, Health Services, Appeals & Grievances, Member, Provider Customer Service, Dental, Behavior Health,

Transportation Vendor, Vision, and Compliance.

6. Able to manage multiple projects across multi-functional teams.

Requirements:

- 1-2+ years of experience in healthcare management, marketing or a related field

- 1-2+ years of successful experience in managed care

- 1-2+ years knowledge of current managed care preferably Medicaid and Government Programs

Preferred Qualifications:

- Bachelor's Degree

 
qualifications:
Description:

1. Assist the A&G and Health Plan team with contacting members, providers and internal matrix partner in order to resolve Grievances.

2. Assist the Health Plan Transportation team with resolving member transportation issues.

3. Documenting issues into the Health Plan complaints tracking log located on the HP SharePoint.

4. Assist with the completion of State Monthly Reports.

5. Claims and Clinical documentation research knowledge

6. Able to work with a SharePoint, Healthcare Management Authorization systems, Claims processing systems, and other software applications (CSP Facets, Sales Force, NDB)

Must have qualifications/experience:

1. Knowledge of working in Microsoft Office (Outlook-Email, Word, PowerPoint and Excel)

2. Knowledge of operating a Copier and Fax Machine

3. Claims research and processing knowledge

4. Excellent verbal and written communication skills

5. Working with cross-function team members from Health Plan Operations, Health Services, Appeals & Grievances, Member, Provider Customer Service, Dental, Behavior Health,

Transportation Vendor, Vision, and Compliance.

6. Able to manage multiple projects across multi-functional teams.

Requirements:

- 1-2+ years of experience in healthcare management, marketing or a related field

- 1-2+ years of successful experience in managed care

- 1-2+ years knowledge of current managed care preferably Medicaid and Government Programs

Preferred Qualifications:

- Bachelor's Degree

 
skills: MS Office
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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