Claims Resolution Manager

Job Summary

A company is looking for a Claims Resolution Manager to oversee health plan claims processing functions.

Key Responsibilities

• Lead the claims resolution team in managing the entire claims lifecycle
• Monitor and report on claim trends, implementing corrective actions as needed
• Train and mentor the claims resolution team, fostering continuous improvement

Required Qualifications

• Bachelor's degree in healthcare administration, business, or related field (or equivalent experience)
• 8+ years of experience in medical claims management, preferably in outpatient billing
• 5+ years of management experience in a fast-paced environment
• Deep understanding of healthcare billing processes, including ICD-10 and CPT coding
• Experience with mental health billing platforms and clearinghouses