Claims Manager

Overview

Required skills & experience: 1. 2+ years of complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system. 2. 2 + years of experience in managed healthcare environment related to claims processing/audit. 3. 2 year(s) knowledge of standard coding and reference materials used in a claim setting, such as CPT4, ICD10, HCPCS and others. 4. 2 year(s) knowledge of CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations. 5. Proficient in processing/auditing claims for Medicare and Medicaid plans. 6. Strong knowledge of CMS requirements regarding claims processing and various Medicare fee schedules; especially Skilled Nursing Facility and other complex claim processing rules and regulations. What you need to know: 1. This position will have supervisory responsibilities. 2. Completes regular review of internally established reporting such as high dollar claims and establishes best practice claims payment methodology based on the latest CMS claims payment rules. 3. Opportunity to join a rapidly growing company with top-notch culture 4. Great benefits and generous PTO 5. This position will start off remote, however you will be expected to work 1-2 days per week in the office once the pandemic has calmed down.

Benefits

Company

We have been at the forefront of delivering exceptional, post- acute care for more than three decades. Our focus on providing compassionate care close to home means you can trust us to be a committed and effective partner in bringing care to your community.