In this management role, responsibilities will include management of all operations, applications and interfaces used to support claims processing. You will work directly with analysts, overseeing the planning and coordinating of all activities as they relate to the claims department, including systems installations, upgrades, and systems development. You will be tasked to improve efficiencies and workflows within the department; enforce a strict change management and documentation process; oversee the integrity of the various claims systems; and be available to address business needs, processes and procedures to support business needs and diagnose claims systems issues, manage systems configuration and documentation, and recommend appropriate solutions for implementation.

For immediate consideration, qualified applicants please submit your resume as a Word doc to: info@engagestaff.com









Qualifications

• Minimum requirements include a BA/BS degree in Computer Science or Information Systems; 5+ years of experience working in Information Systems or Claims with 3+ years working with specialized applications, experience in business re-process engineering and improvement, and management experience.

Job Responsibilities

• The qualified candidate will have excellent MS Office, Access and SQL query development experience; Microsoft SQL Server; IDX MCA, Macess, & EDI formats; experience with managed care/HMO claims processing standards; and advanced understanding of Medicaid, Medicare, and other provider payment/reimbursement methodologies and payment guidelines.