Claims Review Manager

NaphCare has an excellent opportunity for a Claims Review Manager to join our Corporate Headquarters in Birmingham, AL supporting our scheduling teams. The successful Claims Review Manager will play a critical role in our operations by overseeing a team of claims specialists that review authorizations for medical procedures/appointments and reconciling claims.  This position requires data entry skills and the ability to maintain a high volume of work with minimal errors. This employee will serve as a liaison between the scheduling and claims department to assist with timely processing of claims. 

• →Utilize healthcare experience to consistently review medical authorizations in our scheduling system in order to resolve outstanding claims
• →Demonstrate skills in accuracy and multitasking while working to impact progress within the daily workload and adhere to internal deadlines
• →Manage team of Claims Review Specialists to ensure that claims are being worked timely with minimal errors
• →Develop and deliver regular reports on team analytics and key performance metrics
• →Independently identify and resolve operational challenges, and proactively recommend and implement improvements to processes and workflows that increase efficiency and accuracy
• →Maintain confidentiality when managing medical records, patient data, and NaphCare processes
• →Demonstrate a high comfort level in working with large volumes of data
• →Demonstrate a strong attention to detail
• →Additional duties and specific projects as assigned

• High School Diploma or equivalent required; Associate's or Bachelor's degree in healthcare administration, business, or a related field preferred.
• Three (3) years minimum experience in a healthcare claims, billing or medical authorization setting.
• Ability to prioritize, delegate, and meet deadlines in a high volume environment.
• Working knowledge of medical claims, medical terminology, medical records, and medical authorization processes.
• Strong written, verbal and organizational skills.
• Working knowledge of claim demographic information.
• Computer skills, including proficiency in Microsoft Office Suite, particularly Excel.

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