Client needs someone with solid management in a medical claims setting involving Medicare and Medicaid claims.
Search For:  manager, medical claims, Medicare, Medicaid.

Relocation               Yes
Location                  Cincinnati

This position is primarily responsible for leadership and management of the daily workflow of the Government Services Division.
.Interview, hire, train, audit and review team members
.Lead, supervise, motivate and monitor team members to ensure compliance with policies, procedures and standards
.Support and assist team members with difficult issues concerning work and offer suggestions to assist in the process of underpayment reviews and collections
.Ensure team successfully achieves quality, productivity and collection goals
.Build strong, lasting relationships with clients, carriers and personnel
.Attend client, department and company meetings
.Investigate various issues with Medicare and Medicaid carriers and contracts; respond to questions and resolve problems
.Perform duties and responsibilities of Claims Analysts as needed
.Comply with federal and state laws, company policies and procedures

Job Requirements :
.Minimum 5-years management experience in an operational setting, preferably in managed care, insurance company or patient accounts
.High school diploma or equivalent
.Moderate computer proficiency including experience with Microsoft Windows, Word and Excel
.Advanced proficiency in conducting Internet searches and Internet navigation through use of Internet Explorer
.Analytical and problem solving skills
.Ability to calculate rates using addition, subtraction, multiplication and division
.Ability to read and interpret extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form
.Ability to define problems, collect data, establish facts and draw valid conclusions
.Ability to work on own with minimal supervision and use effective time management skills to complete tasks on time
.Ability to travel by automobile or public transportation to visit worksites
.Excellent leadership, interpersonal and communication skills, strong team player and commitment to company values
.Knowledge of Medicare and Medicaid claims submittal process and procedures and medical forms (including UB04 and CMS1500) a plus

Competitors (Sources):
National Government Services
Humana

Requirements:
1.  5 + years management experience in an operational setting involving Medicare and Medicaid claims preferably in managed care, insurance company or patient accounts.
2.  High school diploma or equivalent.
3.  Moderate computer proficiency and advanced proficiency in conducting Internet searches and Internet navigation through use of Internet Explorer.
4.  Experience with Medicare and Medicaid claims submittal process and procedures and medical forms (including UB04 and CMS1500).
5.  Local or located within the region for a short easy move.