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Healthcare Claims Operations Leader

2 months ago

Dallas, Texas, United States CornerStone Staffing Full time

Position Overview: Are you seeking a remote opportunity that allows you to leverage your expertise in Healthcare Reimbursement Operations and Call Center Management? If you possess a strong background in these areas, we invite you to consider joining our team.

About the Role: As a Healthcare Reimbursement Operations Manager, you will play a pivotal role in a leading healthcare organization that is currently experiencing significant growth. We are in search of dedicated professionals who are committed to providing exceptional customer service and have a passion for the healthcare sector.

Key Responsibilities:

  • Oversee a remote or field-based team within a designated Micro-Hub, acting as the primary liaison between your team and the broader organization.
  • Lead and mentor Supervisors and Hub Leads managing remote, seasonal Reimbursement Specialists.
  • Ensure compliance with company standards and excellence in customer service during critical periods.
  • Provide analytical support through data and reports to monitor key performance indicators.
  • Assist in resolving complex reimbursement challenges and escalated issues.
  • Collaborate with other management team members to enhance Hub operations.
  • Monitor team performance and implement necessary improvements.
  • Independently address complex management issues.

Qualifications:

  • A minimum of 4 years of supervisory or management experience in medical insurance, healthcare reimbursement, or related fields.
  • In-depth knowledge of healthcare reimbursement processes, including benefits investigations, coding and billing, and appeals management.
  • Experience in managing diverse teams, with a preference for remote management experience.
  • A Bachelor’s degree or relevant Practice Management experience is preferred.

Essential Skills:

  • Strong understanding of private payer, Medicare, and Medicaid reimbursement processes.
  • Familiarity with patient privacy laws, including HIPAA.
  • Technical expertise in healthcare reimbursement, coding, billing, and appeals.
  • Exceptional leadership, problem-solving, and communication skills.
  • Ability to effectively manage and coach a diverse remote workforce.
  • Proficiency in Microsoft Excel, Word, and PowerPoint.

Application Process: Candidates will undergo a background check, virtual interview, and basic clerical assessments as part of the application process.