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A detailed look at your job responsibilities: Departmental Responsibilities o Oversee the consistency of processes and procedures by creating, maintaining and enforcing standards and best practices. o Maintain a working knowledge of all regulatory and compliance guidelines that affect the scope of the department. o Direct operations in executing production and procedures according to a documented schedule that meets end user/clients' expectations. o Able to think strategically and translate strategies into actionable items o Serve as liaison and interfaces with other department Directors and Vice Presidents regarding department activity and issues. o Responsible for the management and oversight of departmental functions such as: claims adjudications, appeals, correspondence, claims adjustments, claims support, etc. o Responsible for driving process automation, including auto-adjudication. o Drive continuous improvement across the organization to ensure service levels are met, including: TAT, quality, productivity, customer satisfaction, and deliver on SLA's and performance. Employee Management o Ability to communicate effectively to all levels of employees and demonstrate empathy and practice active listening o Actively participates in hiring staff. o Ability to demonstrate the on-going development of a high performance team while maintaining a positive work environment o Coach and direct department performance by setting clear goals and expectations; track progress against goals. o Conduct regular performance evaluation of direct reports and provide ongoing feedback and coaching as necessary to achieve service, quality and production goals. Perform annual reviews in a timely manner. o Address and counsel employees on behavioral or performance problems and implements corrective action as necessary. o Plan and direct workflow. o Frequently analyze staffing matrix and adjust accordingly o Explain and administer company policies. o Appropriately share pertinent department and company information with staff in a timely manner. o Administrative o Determine the strategic goals of the Company within broad outlines provided by the executive team. Through research and evaluation, recommends and plans service delivery to support and meet company objectives. o Develop annual budget and administer according to Company guidelines. o Maintain a working knowledge of the latest developments in claims management and remain highly technically competent at all levels. o Implement policies that more effectively utilize claims and other resources. Customer Service o Provides timely and thorough follow up with staff, internal and external customers. o Appropriately escalates difficult issues up the chain of command. o Acts as a role model in demonstrating the core values in customer service delivery Quality Assurance o Serves on committees, work groups, and/or process improvement teams to assist in improving quality/customer satisfaction. o Recognizes and alerts appropriate member of the Executive Team of trends that fall outside of quality parameters. o Performs self quality monitoring in order to develop and execute plans to meet es
Medical Coding, Claims Processing, Insurance Claims, Medical Claims, Medical Appeals, Medical Denials, Medical Terminology
Robert Half Finance & Accounting, the world's leader in specialized financial staffing, provides exciting full-time opportunities in the areas of accounting, bookkeeping, finance, audit, taxation and more. We pioneered the professional staffing industry, and we've been successfully matching professionals with employers since 1948. Our proven proprietary processes, along with our relationships in 325 locations worldwide, allow us to provide you unparalleled access to exciting career opportunities. But don't take our word for it. Our company has appeared on Fortune magazine's list of \"World's Most Admired Companies\" since 1998, and 9 out of 10 of our customers would recommend our service to a colleague.
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2019 Robert Half Finance & Accounting. An Equal Opportunity Employer M/F/Disability/Veterans
Associated topics: auto, bodily, casualty, claim adjuster, insurance adjuster, insurance examiner, insurance investigator, investigate, liability adjuster, title examiner