Imagenet is a premier healthcare technology company that has taken Enrollment for our Clients to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient processing services.
This is NOT a remote position. You must be able to work out of our Phoenix office.
· Ensure compliance will all corporate and departmental standards
· Meet with employees on a regular basis to discuss performance and quality
· Report on Key Performance Metrics (KPIs) to the Executive Director of Claims
· Ensure adequate resources and technology are in place
· Develop and implement departmental standards and expectations
· Analyze and process a variety of claim files to ensure the execution of standardized claim protocol and claim handling
· Oversee the Enrollment process for contracted lines of business according to the business rules taught in the training progra sinm.
· Ensure that the department practices meet or exceed the client’s processing standards, procedures and service level agreements
· Must be knowledgeable in healthcare and the enrollment process for health plan recipients.
· Identify process improvement opportunities within the Enrollment process and recommend system enhancements;
· Handles any additional responsibility which may be assigned
· Interact with Client on a daily basis to ensure the communication is a positive one and we are managing the SLAs together.
· High School Diploma or equivalent required
· AS / BS Degree Preferred
· One to three years’ experience working in a claims processing or Health Insurance environment required
· One to three years’ experience managing staff to quality and performance metrics.
· Three to Five years’ management experience preferred
Technical Skills / Knowledge:
· Understanding of health claims processing
· Ability to perform basic to intermediate mathematical computation routines
· Medical terminology strongly preferred
· Understanding of ICD-9 & ICD-10
· Basic MS office computer skills
Other Skills Required
Ability to work independently or within a team
Time management skills
Written and verbal communication skills
Attention to detail
Must be able to demonstrate sound decision making skills