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Claims and Mailroom Operations Leadership

2 months 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 can thrive. We celebrate diversity and are proud to be an Equal Opportunity Employer.