Claims Processing Manager jobs in Georgia

JOB DESCRIPTION

The Supervisor of Claims Processing is a people leader role responsible for providing leadership, support, and development of Claim Examiners and Claim Processing Coordinators. This role is responsible for departmental daily work distribution, team performance, and engaging and leading a claims processing workforce while ensuring turnaround times and accuracy results meet or exceed our customer expectations.

RESPONSIBILITIES

• Oversees the day-to-day operations of Claims Processing staff and functions. Supervises staff including determining staffing needs, setting goals, interviewing, selecting, coaching, recognizing, and evaluating the performance of all direct reports.
• Monitors workload and inventory within the department; re-allocates the claims workforce and respective staff as needed to maintain efficiency, accuracy, and meet established performance expectations.
• Monitors adherence to customer performance guarantees and develops and implements corrective actions as needed.
• Ensures that training is delivered to staff on an ongoing basis and collaborates with the department and/or enterprise trainer to develop training materials and procedures.
• Evaluates work processes to identify opportunities for reducing error trends and increasing productivity through automation leading to improved operational efficiencies.
• Reviews and approves recommended training as proposed by, but not limited to; Claim Coordinators, Claims Audit & Enablement team.
• Resolves complex escalated claims processing issues.
• Provides support in the proper implementation of claims processing regulatory and compliance requirements. Balances the requirements of multiple major commercial and government clients including performance guarantees and processing turnaround time requirements.

QUALIFICATIONS

• 5 years as IC w/Associate's degree; 0 years supervisory
• Minimum 4 years' experience in insurance claims role (or comparable experience); or relevant degree with 1 year supervisory/management experience.
• Strong organizational/time management skills and multi-tasking abilities.
• Interpersonal and communications skills to work effectively with all levels of staff.
• Critical thinking and analytical skills to identify and evaluate business solutions.
• Working knowledge of claims processing flow and adjudication required.
• Ability to interpret, develop and ensure adherence to enterprise and departmental policies and procedures.
• Licenses
  
  
  • Six Sigma Green Belt Certification. within 180 Days Pref'

Base Pay Information

The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. $52,000 - $104,300

ADDITIONAL INFORMATION

Rewards to make you smile! We don't just want to make our customers happy - we want to give our employees a reason to smile, too. Delta Dental's comprehensive benefits package includes:

• Generous paid time off plus 12 holidays and your birthday off!
• Low-cost premium medical insurance options
• 100% paid dental and vision insurance
• Generous 401(k) matching and flat contribution
• Social responsibility and volunteer opportunities, including 16 paid volunteer hours annually
• Employee LiveWell program, focusing on overall employee well-being
• Fertility and diabetes benefits
• Employee discount program: AT&T/Verizon, entertainment, travel, and more!
• Culture of learning: career development and tuition reimbursement
• Career growth: we love promoting from within

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

#LI-Hybrid

ABOUT THE TEAM

At Delta Dental, our success is only as strong as the people who execute it! We take enormous pride in being the nation's most recognized and widely-used provider of dental insurance - and we've come this far by living our core values of innovation, excellence, service and trust. Our vision is to motivate and empower every employee so that we're all inspired to take exceptional care of our customers, providers and ourselves. We believe in integrity, accountability, collaboration, and giving every employee equitable opportunity for their voice to be heard and development to be fostered.

If you're excited about the prospect of transforming the future of health care and growing in your career, join our smile revolution!

To see some of the smiling faces behind Delta Dental and to learn more about what our values and culture look like in action, connect with us on social media: Delta Dental Ins. on Facebook and Instagram, #LifeatDDins on Facebook and Instagram, Delta Dental Ins. on Twitter and Delta Dental Ins. on LinkedIn.

We are part of the Delta Dental Plans Association, a network of companies that provides dental coverage to 74 million people in the U.S. Delta Dental of California, Delta Dental of New York, Inc., Delta Dental of Pennsylvania and Delta Dental Insurance Company, together with our affiliate companies, form one of the nation's largest dental benefits delivery systems, covering 33 million enrollees. All of our companies are members, or affiliates of members, of the Delta Dental Plans Association, a network of 39 Delta Dental companies throughout the country.

Delta Dental is an equal opportunity employer. We are committed to building and maintaining a diverse and inclusive workplace for all employees. Applicants will not be discriminated against because of race, color, religion, creed, national origin, ancestry, citizenship status, sex (including pregnancy), sexual orientation, gender or identity expression, age, disability, marital status, medical status, veteran status or any other status protected under federal, state, or local law. In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, North Dakota, Nebraska, Hawaii, Oklahoma, Vermont, Maine, West Virginia, New Hampshire, Wyoming, Puerto Rico or other US Territories at this time.

Proof of eligibility to work in the United States must be provided if selected for hire.

Delta Dental* has enacted a COVID-19 vaccination policy to protect all employees and the communities we serve due to the ongoing impacts of the COVID-19 pandemic. Accordingly, we require all employees to be fully vaccinated for COVID-19. Are you able to comply with our policy of being fully vaccinated by your start date if an offer is made or have a medical or sincerely held religious exemption for receiving a COVID-19 vaccine? Failure to comply with our policy and submit proof of compliance or receive approval for a valid medical or sincerely held religious belief exemption prior to your start date will nullify any offer of employment extended to you.

• Delta Dental includes: Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania, and Delta Dental of New York