Jail Claims Manager

Overview:

NaphCare is hiring an experienced Claims Managerjust like you to join our team at our Corporate Office in Birmingham, AL.

*This is not a remote postion*

NaphCare is a family owned, medical technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 30 years. Come join our team of over 6000 employees and growing NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do.

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare as you use our cutting-edge resources, including our award-winning electronic operating system.

NaphCare Benefits for Full-Time Employees Include:

• Prescriptions free of charge through our health plan
• Health, dental & vision insurance that starts day one
• Employment Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one
• Tuition Assistance
• Referral bonuses
• On-site education
• Free Continuing Education
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays

NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up to date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing.

With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry. If you want a career that will make a difference, choose the company that is different.

We support your growth and internal promotion. Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.

Responsibilities:

• Analyze reports and review internal audits to ensure benchmarks are met.
• Handle escalations with Claims team members, clients, and providers to ensure a resolution is achieved.
• Appropriately communicate information both verbally and in writing to clients, team members, and supervisors.
• Communicate with other departments as needed to ensure claims are processed accurately and timely.
• Assist with training team members on client specific processes and payment methodologies.
• Delegate tasks to the team appropriately and provide support to the team members.
• Utilize medical terminology knowledge to review claims, medical records, and authorization scenarios.
• Exhibit a high comfort level in working with large volumes of data.
• Demonstrate a strong attention to detail and a commitment to customer service throughout the claims process.
• Work closely with the Director of Claims to ensure claims processes and systems are operating as expected.
• Additional duties and specific projects as assigned.

Qualifications:

• Associated Degree required
• 2+ years supervisory/managerial experience in medical claims adjudication
• 3+ years of medical claims processing
• Medicare/Medicaid claims processing experience preferred
• Knowledge of Medicare guidelines and payment methodologies
• Knowledge of medical terminology, ICD9, HCPCS and CPT coding, and an ability to understand medical records.
• Strong leadership and training skills
• Strong follow-up skills
• Proficiency in Microsoft Office Suite and strong written and verbal communication skills required.

We know you may have questions before applying. To speak to a recruiter directly, email your questions and/or resume to with the position and location you're interested in.