Claims Processing Manager jobs in Arizona

Claims Processing Manager manages the administration of health insurance claims, payment processing, billing research, and responding to inquiries. Ensures timely and proper disposition of claims in accordance with coverage amounts. Being a Claims Processing Manager trains staff on organizational policies and ensures procedures are followed at all times. Provides guidance on more complex or high-value claims. Additionally, Claims Processing Manager typically requires a bachelor's degree. Typically reports to a head of a unit/department. The Claims Processing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Claims Processing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

S
Clinical Operations Manager
  • Sterile Processing Express
  • Phoenix, AZ FULL_TIME
  • SUMMARY:

    The Clinical SPD Manager is responsible for providing effective leadership and directing 24/7 operations of the SPDx Sterile Processing facility to deliver quality, efficient, cost-effective decontamination, sterilization, and distribution services.


    ESSENTIAL DUTIES:

    • Manage the day-to-day operations of the SPDx facility: check-in, decontamination, inspection, assembly, sterilization, delivery, tracking.

    • Develop facility staffing, revenue, and expense budgets and having direct responsibility for adhering to those goals, including responding to changes in the business, which may affect the ability to achieve the budget goals.

    • Lead a team of Set Technicians and Mobile Technicians to coordinate daily workload activities and ensure instrument set, implant, and medical device orders ship to meet the customer’s request dates and times.

    • Work collaboratively with surgical facilities customers and Orthopedic Instrument manufacturers to deliver effective and efficient services.

    • Monitor surgery schedule of cases to assure proper instruments are available.

    • Accomplish monthly productivity and quality goals through effective and efficient use of resources.

    • Establish processes and procedures to ensure consistency and compliance with Federal Drug Administration (FDA) and other quality/regulatory protocols.

    • Maintain detailed records in accordance with quality control and regulatory standards.

    • Screen and hire SPDx teammates and ensure teammates receive the appropriate training for their role and ensures efficient and safe product handling.

    • Assign work, manage, and evaluate performance.

    • Conduct performance reviews and recommends or initiates personnel actions (promotions, transfers, discharges, disciplinary actions, etc.) as required.

    • Create professional development plans for staff.

    • Lead SPDx operations in implementing Lean principles for continuous process improvement.

    • Provide expertise and knowledge in operation, maintenance, parameters, policies, and procedures regarding infection control, disinfection, and sterilization.

    • Provide input and guidance on the correct resources, processes, and space needed for the operation.

    • Ability to meet physical demands and perform the essential job functions within the work environment, including travel requirements identified in this job description.

    • Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.


    SUPERVISORY RESPONSIBILITIES:

    • Sterile Processing Technician

    • Mobile Inventory Technician

    EDUCATION AND EXPERIENCE REQUIREMENTS:

    • Five or more years of experience in an operating room, instrument room, or ambulatory surgery center (intraoperative)

    • Three or more years in a management or leadership position in an acute or ambulatory setting

    • Certified Healthcare Leader Training required

    • Post-high school program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) preferred

    • Associate’s or bachelor’s degree in healthcare or similar field preferred

    • Certified Registered Central Service Technician preferred

    • Experience as a Register Nurse preferred

    • Experience with orthopedic set loaner program preferred

    SKILLS & KNOWLEDGE REQUIRED:

    • Knowledge of current regulations and requirements (AAMI, AORN, JCAHO, etc.)

    • Demonstrated experience in curriculum design, development, and delivery

    • Working experience with surgical instruments, sterilization, and processing

    • Strong people management and development skills

    • Fluent with automated instrument tracking systems

    • Proficient in Microsoft Suite, including Excel and Word

    • Outstanding organizational and problem-solving skills

    • Able to read and comprehend written and oral instructions

    • Verbal communication skills


    PHYSICAL DEMANDS AND WORK ENVIRONMENT:

    The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

    • Physical Demands:

    o While performing the duties of this job, the employee must be able to remain in a stationary position for extended periods of time and be able to move about inside the facility to access file cabinets, office machinery, etc.

    o Operate a computer as well as the ability to operate, set up, adjust, and test with sanitization equipment.

    o Constantly communicate and exchange information with team members and must be able to effectively communicate correct information to customers vendors.

    o Read/comprehend, write, communicate orally, reasoning, and analytical abilities, and mental flexibility.


    Occasionally climb, bend, squat, kneel, crouch, and reach above shoulder when working with equipment, chemical mixing, materials movement, and other related tasks Occasionally move objects up to 50 pounds.

    Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus to compare and distinguish material grades, analysis reports, and administrative data Hearing ability to perceive the nature of sounds at normal speaking level with or without correction. Ability to receive detailed information through oral communication and to make discriminations in sound.

    • Work Environment:

    o While performing the duties of this job, the employee is regularly working in a typical sterile processing department environment.

    o Exposure to hazardous materials, extreme heat, and proximity to moving mechanical parts.

    o Requires wearing common protective and safety equipment.

    o Position may involve extended work hours.

    o The noise level in the work environment is usually moderate.

    TRAVEL: This position requires travel (10%) of the time. Maintain a valid Driver’s License.

  • 1 Month Ago

C
AZ - Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Phoenix, AZ FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA. Copper Claims Services excels in providing custom claims solutions fo...
  • 1 Month Ago

T
Processing Manager
  • Tri Pointe Homes Holdings, Inc.
  • Scottsdale, AZ FULL_TIME
  • Overview Are you interested in joining a company culture where accountability, top performance, and teamwork are valued and rewarded? Tri Pointe Homes is dedicated to insightful design and superior cr...
  • 17 Days Ago

R
Processing Manager
  • Rehrig Pacific Company
  • Buckeye, AZ FULL_TIME
  • ***Hiring for Spring 2024 - May hire sooner to conduct training in our Los Angeles facility.*** Here at Rehrig Pacific, we are all about our people. Since 1913, our organization has focused on sustain...
  • 1 Month Ago

H
Household Manager
  • Hiring Manager
  • Phoenix, AZ FULL_TIME
  • We are seeking a dedicated and organized individual to join our household as a Household Manager. The ideal candidate will take charge of various tasks related to the care of our little one, manage ho...
  • 22 Days Ago

O
Manager, Claims Optimization
  • Oscar Health
  • Tempe, AZ FULL_TIME
  • Hi, we're Oscar. We're hiring a Manager, Claims Optimization to join our Claims Design team. Oscar is the first health insurance company built around a full stack technology platform and a focus on se...
  • 17 Days Ago

Arizona (/ˌærɪˈzoʊnə/ (listen); Navajo: Hoozdo Hahoodzo Navajo pronunciation: [xòːztò xɑ̀xòːtsò]; O'odham: Alĭ ṣonak Uto-Aztecan pronunciation: [ˡaɺi ˡʂonak]) is a state in the southwestern region of the United States. It is also part of the Western and the Mountain states. It is the sixth largest and the 14th most populous of the 50 states. Its capital and largest city is Phoenix. Arizona shares the Four Corners region with Utah, Colorado, and New Mexico; its other neighboring states are Nevada and California to the west and the Mexican states of Sonora and Baja California to the south and so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Manager jobs
$92,512 to $119,485

Claims Processing Manager in Topeka, KS
Managers can review workflow queues and see what is in each processor’s queue.
January 13, 2020
The claims have to be handled timely to ensure quick settlement leading to customer satisfaction.
January 12, 2020
Claims Processing Manager in Pittsburgh, PA
Depending on the employer’s needs, insurance claims and processing clerks may also be responsible for interviewing clients to obtain the information required on new insurance policy applications.
January 27, 2020
Claims Processing Manager in Medford, OR
Claims Manager Plus ingests a hospital’s daily claims file and runs it through a sophisticated rules engine to modify claims based on the hospital’s defined configurations, as well as parse out claims not meeting criteria for payment.
December 11, 2019