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Claims Manager

2 months ago

Miami, United States AppleOne Employment Services Full time

We are seeking a seasoned Claims Manager to lead our claims operations team in the Coral Gables, FL area. This is an on-site position with one of our top clients in the insurance services industry.

In this role, you will oversee the day-to-day claims process, ensuring quality and compliance with industry standards and state regulations. Your leadership will be crucial in maintaining professional relationships and achieving set goals.

Key Responsibilities:

  • Supervise the claims department to ensure efficient workflow and timely processing.
  • Oversee the Claims Examiner Department to optimize claims processing and maximize client savings.
  • Perform quality assessments to minimize errors and identify claims for auditing.
  • Coordinate with other departmental supervisors to maintain operational processes.
  • Implement new procedures and train staff in claims handling.
  • Provide regular updates to clients on claims status.
  • Keep staff informed on company, department, and organizational issues.
  • Advise management on issues and suggest improvements.

Requirements:

  • Knowledge of medical claims coding (CPT, ICD 9/10), medical specialties, and services billed to insurance companies.
  • Experience in claims evaluation, adjudication, and customer service.
  • Ability to manage and train a team of claims professionals.
  • Strong communication skills for client follow-ups and internal coordination.

Apply today to join our team of insurance professionals