Operations Director, Claims and Mailroom Management

2 weeks ago


Roseville, California, United States Gainwell Technologies Full time

Job Summary:

We are seeking an experienced Operations Director to oversee the claims processing operations at Gainwell Technologies. As a key member of our team, you will be responsible for ensuring the effective management of all related activities.

Key Responsibilities:

  • Manage the claims processing operations, including the final disposition of claims, Treatment Authorization Requests, Claim Inquiry Forms, and Resubmission Turnaround Documents.
  • Supervise personnel responsible for claims processing operations and ensure they have the necessary resources and support to perform their duties effectively.
  • Develop and implement policies and procedures to improve the efficiency and effectiveness of claims processing operations.
  • Collaborate with other departments to ensure seamless integration of claims processing operations with other business functions.
  • Monitor and analyze key performance indicators to identify areas for improvement and implement corrective actions as needed.

Requirements:

  • Bachelor's degree in a related field, such as business administration or healthcare management.
  • Minimum of four years of experience managing healthcare claims processing operations and personnel for a government or private sector healthcare payer.
  • Supervisory/administrative experience in the execution and/or evaluation of Medicaid program policies.
  • Excellent verbal, written, and presentation communication skills.

What We Offer:

  • A competitive salary range of $121,000 to $174,100 per year, depending on location, internal equity, and other factors.
  • A generous, flexible vacation policy.
  • A 401(k) employer match.
  • Comprehensive health benefits.
  • Educational assistance.
  • Leadership and technical development academies to help build your skills and capabilities.

About Gainwell Technologies:

We are a diverse, equitable, and inclusive workplace committed to creating an environment where all employees feel valued and supported. We are proud to be an Equal Opportunity Employer and celebrate diversity in all its forms.



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