Healthcare Claims Subject Matter Expert

Job Summary

A company is looking for a Subject Matter Expert who will manage and supervise the Claims Team to ensure compliance with regulatory standards and contractual obligations.

Key Responsibilities

• Provide direction, leadership, and mentoring for the claims staff
• Interact with clients to resolve issues and provide necessary production information
• Review and analyze claims processing, including quality and production reports

Required Qualifications

• Bachelor's degree or equivalent experience is required
• Thorough knowledge of medical terminology and claims processing procedures
• At least 1-3 years of healthcare claims processing experience
• Experience in supervising staff and conducting performance evaluations
• Knowledge of HIPAA regulations and Microsoft Office Suite, especially Excel