Mark Powers

Recruiting Consultant at HealthCare Support Staffing

4.85

Job

Senior Claims Auditing Manager

DIRECT HIRE

TERMS: direct hire

Job Description:

Lead daily claims operations to ensure quality, accuracy, and timely processing
Manage claims inventory and prioritize workloads to consistently meet SLAs
Support onboarding and implementation of new IPAs and claims operations
Drive continuous improvement initiatives to increase claims efficiency and quality
Resolve claims processing issues and escalations across assigned teams and IPAs
Use claims systems and reports to monitor performance and share insights with leadership
Coach, train, and develop claims staff (including offshore teams) to meet performance expectations
Partner with internal teams on system updates, process improvements, and compliance needs
Handle sensitive provider/member inquiries and high?level claim issues as needed
Other duties as assigned