Senior Claims Manager Job Listing at Kelly Services in Tampa, FL (Job ID US3575415_BH9872323)

Description

Senior Claims Manager
Location: Tampa, FL
Salary: $90,000-110,000
Direct Hire Opportunity!

Kelly Services has an amazing opportunity for a driven Senior Claims Manager to join a leading 3rd party Health Benefits Administrator based out of their Tampa, FL location.  This is a Direct Hire opportunity with a salary range of $90,000-110,000 per year based on experience, in addition to an excellent benefits package.  In this role you will provide operational leadership to the team responsible for processing the billing for healthcare services provided to patients. Further, this candidate will develop and share knowledge of products, benefits, quality requirements and organization procedures. Apply today for immediate consideration!

Responsibilities include but not limited to:

• Support claims leaders and team members to ensure claims are allowed or denied based on actual services rendered, legislative requirement and plan agreements.
• Direct and lead claims processing function for claims leaders and team members ensuring metrics are met or and exceeded; incorporating positive feedback and reward mechanisms 
• Hire and manage staffing levels to ensure continuous, quality processing
• Conduct effective resource planning to maximize productivity and turn-around time
• Follow and maintain knowledge of Federal and State regulations; implement changes regarding claims and billing requirements
• Recommends and implements best practices to ensure complete and thorough claims settlements, legal reviews, and investigations following company policy and insurance regulations
• Develop, revise and monitor metrics in order to meet division quality, time service and productivity goals  
• Prepare and present repots on claims processing metrics, trends, and outcomes 
• Monitor inventory levels and aging of claims and assist with workflow assignments.
• Provide expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claim
• Develop and implement training for employees, collaborating with the training and auditing functions to supplement and support as needed
• Determines the value of settlements for escalated claims
• Identify and coordinate resources for re-work
• Analyze and identify trends and provide robust reports

Skills and Requirements:

• Bachelor's degree in a field related to managing claims in the healthcare field such as business administration, accounting, finance, or a related field or equivalent experience
• 5+ years of experience in a supervisory role in a healthcare claims processing role where HIPPAA and HITECH standards are utilized
• Experience with benefit administration platforms such as Javelina preferred
• Knowledge of Federal and State codes related to fiscal operations of healthcare services
• Knowledge of medical terminology and Diagnosis Codes (ICD-9 & ICD-10)
• Ability to analyze and interpret problems in data collection, billing, and coding. Determine the source of the problem and apply a solution 
• Must be able to calculate and re-calculate claims; performing (sometimes complicated) calculations, applying formulas using multiplication and percentage
• Solid working knowledge of standard computer applications including MS Word, Excel, Outlook, and PowerPoint

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.

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About Kelly

Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

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