Currently looking for a Claims Director
The Claims Director will be responsible for providing direction and leadership to the claims department along with managing day-to-day operations including scheduling of resources, monitoring of performance, workflow, and budget. Responsible for all billing, collection operations, accounts payable, agency set up and fee schedule.
* Develop leadership skills of supervisors and develop staff to respond to department needs, as well as assisting the Claims staff with career development goals.
* Identify training needs, establish and implement delivery strategy for staff level employees.
* Effectively plan staff responsibilities and manage activities, utilizing staff resources to meet department goals in accordance with established business plans and budgets.
* Select, develop and manage staff to ensure appropriate staffing levels to ensure delivery of timely, high quality customer service
* Develop, recommend and implements short and long term objectives consistent with company business goals, guidelines and programs.
* Assure that staff makes any corrections and/ or adjustments to authorizations.
* Assure that claims form (invoice) for each patient will be made by using the information received.
* Ensure that dates of service on each claim form will then be checked against the previous 1500 form to make sure that no dates have been duplicated or billing periods have been missed.
* Oversee that all services are billed according to the contract pricing in place.
* Guarantee that all claim forms are signed, dated and printed, and processed appropriately.
* Override denials and payments as necessary.
* Review claim forms for content, accuracy, current authorization numbers and other billing documentation that is required by the insurance carrier.
* Ensures that all claim forms are mailed appropriately to the respective insurance carrier and/ or other responsible parties.
* Run a detailed Accounts Receivable Report by patient monthly.
* Resubmit all unpaid claim forms past due by 30 days or older from date billed.
* Ensure that payments are posted to each patients account timely and appropriately.
* Travel and attend meetings as needed for company business.
* Maintains all master files in computer.
* Reconciles all claims against authorizations.
* Other duties as assignedQualificiations:
About Aerotek:Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek’s people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit aerotek.com.
- Possess the necessary management skills and/or experience to manage the Claims Department.
- Required to uphold the principles of compliance as outlined in the Code of Conduct, Employee Handbook and related policies and procedures.
- Extensive Claims processing experience from a health plan.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email firstname.lastname@example.org for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.
Location/Region: Hanover, MD (US)