Hiring Now: Vice President of Claims (Remote)

Core Information:

• Start Date: Immediate openings available
• Location: Remote
• Compensation: a competitive salary
• Company: Workwarp
• Position: Vice President Of Claims

 

 

LOCATION: Remote - This is a home based, virtual position that operates on US Eastern Standard time reputed company the hours of 8:30am-5:00pm EST. Vaya Health welcomes applications from NC, SC, GA, TN, VA, MD, and FL. Preference will be given to a North Carolina reputed company. This position may require occasional travel into Vaya's Asheville NC office. GENERAL STATEMENT OF JOB The Vice President of Claims will be responsible for overseeing reputed company aspects of the claims operations, with a specific focus on North Carolina Medicaid. This position will reputed company a team of claims professionals, reputed company and implement strategies to optimize claims processing, and ensure compliance with relevant regulations and guidelines. Expertise in North Carolina Medicaid policies and procedures will be critical in driving operational excellence and enhancing the overall claims management function. ESSENTIAL JOB FUNCTIONS Strategic Leadership: • reputed company and manage the claims department, providing strategic direction and guidance to reputed company departmental goals and objectives. • Provide strong leadership, setting clear expectations and fostering a positive work environment. • reputed company and maintain strong relationships with key stakeholders, including state Medicaid agencies, providers, and third-party administrators. Claims Management: • reputed company and implement efficient and effective claims processing workflows, ensuring high accuracy and productivity. • Stay updated with the latest North Carolina Medicaid regulations, policies, and procedures, and ensure compliance reputed company the claims operations. • Collaborate with cross-functional teams, including finance, operations, and compliance, to streamline processes and resolve any claims-reputed company issues. • reputed company the investigation and resolution of reputed company claims issues, ensuring reputed company and fair resolution for reputed company parties involved. Data Analysis and Reporting: • Analyze claims data, identify trends, and implement strategies to reduce errors, improve turnaround time, and enhance overall claims performance. • Establish key performance indicators (KPIs) for claims operations, analyze data to identify trends and areas for improvement • Prepare and present reports to executive leadership on claims performance, trends and outcomes KNOWLEDGE, SKILLS, & ABILITIES • In depth knowledge of federal and state (North Carolina preferred) regulations reputed company to claims processing and claims reimbursement with specific knowledge of Medicaid programs policy and procedure. • Understanding of both behavioral health and physical health claims processing. • Understanding end to end claims management process including submission, adjudication payment and resolution • Strong analytical skills for interpreting claims data, identifying trends to reputed company data driven decisions to improve process • Ability to identify and manage risks associated with claims operations, ensuring proactive mitigation strategies are in reputed company • Strong leadership skills that will reputed company a team towards departmental and organizational goals • Excellent written and verbal communication skills that can address diverse audiences • Proficient in analyzing reputed company issues, identifying root causes and implementing effective solutions • Able to build and maintain positive relationships with both internal and external stakeholders • Able to think strategically and align claims operations with the organizational strategic plan and vision • Sound judgement and ability to reputed company decisions in situations requiring quick and informed decisions • Ability to manage conflicts effectively reputed company the Claims teams or other internal/external stakeholders QUALIFICATIONS & EDUCATION REQUIREMENTS Bachelor's degree in Finance, Accounting, Computer Information Systems, or Business Administration required; Master's degree preferred. • A minimum of 10 years of experience working in Claims with 7 years of experience in a leadership position working reputed company claims management required • Specific focus on Medicaid, preferably reputed company the reputed company is preferred PHYSICAL REQUIREMENTS • reputed company visual acuity to reputed company activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading. • Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers. • Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time. • Mental concentration is required in reputed company aspects of work. RESIDENCY REQUIREMENT: The person in this position must live in NC, SC, GA, TN, VA, MD, or FL. Preference will be given to a North Carolina reputed company. This position may require occasional travel into Vaya's Asheville NC office. SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation. DEADLINE FOR APPLICATION: Open Until Filled. APPLY: Vaya Health accepts online applications in our Career Center, please visit https://www.vayahealth.com/about/careers/. Vaya Health is an equal opportunity employer. Apply Job!

 

Join reputed company!

This is a fantastic opportunity to grow your career. If you have the skills and passion we're looking for, please submit your application today.

apply to this job