Manages the operational activities and staff in claims in accordance with Company guidelines, client needs, and legislative requirements.
“Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role.”
Manage staff, demonstrating leadership qualities consistent with management values and mission.
Develop staff through performance management, goal setting, training, and effective employee relations.
Oversee the quality and quantity of work produced, ensuring employees are held accountable and expectations are consistently met.
Develop and manages staffing and departmental budget to ensure efficient operation within budget guidelines.
Develop, implements and monitors internal systems, policies and procedures to ensure operations are in compliance with client needs, new developments, regulations, and reporting requirements.
Resolves customer/client service issues and coordinates the successful implementation of new clients.
Maintains communications and effective working relationships with clients, and responds to requests from clients, government agencies, unions, participants, attorneys, and consultants.
Attends client meetings and interfaces directly with clients on claims-related issues to ensure client requirements and changes in benefit programs are implemented.
Oversees internal systems, policies, and procedures to ensure operations are in compliance with client needs, new developments, regulations, and reporting requirements.
Performs other similar and related duties as required