Medical Claims Director

Medliminal is the leading edge of medical cost containment and we are always looking for amazing talent to help move us forward. We have some of the most qualified people available working with us and we are regarded as the industry leader in medical cost containment. Medliminal sets the standard and while our technology and proprietary processes create our product, our people set us apart.

Position: Medical Claims Director

Job Summary:

The Medical Claims Director is responsible for overseeing and developing strategic objectives within the Consumer Division. They will work closely with clients/prospects, as well as, other team members and management.

Roles & Responsibilities:

· Collaborate with Marketing & Business Development department to identify opportunities and implement HSP dashboard efficiently

· Set up new clients on Health Savings Plan dashboard

· Create business plans and training manuals

· Ability to work on analytics and revisions to Health Savings Plan dashboard

· Train and mentor claims analyst team members

· Resolve issues, manage employee performance, manage physician relations, ensure high quality patient care and service excellence, and ensure operational efficiencies

· Problem-solving skills to research and find solutions to unfamiliar problems

· Direct growth and utilizes team members to achieve goals and complete tasks

· Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems

· Familiarity with CPT and ICD-10 Coding

· Knowledge of medical terminology likely to be encountered in medical claims

· Maintaining HIPAA compliance

Required Skills:

· Medical insurance and billing experience

· Ability to manage personnel

· Proficient in Microsoft Office

· Critical thinking skills, decisive judgement and the ability to work with minimal supervision

· Must be able to work in a fast-paced environment and take appropriate action

· Excellent communication skills

Our Equal Employment Opportunity Policy: To provide equal employment and advancement opportunities to all individuals, employment decisions at Medliminal will be based on merit, qualifications, and abilities and other lawful considerations. Medliminal does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, pregnancy, national origin, age, disability, gender identity or expression, sexual mentation, genetic information or any other characteristic or status protected by law.

Job Type: Full-time

Experience:

• relevant: 1 year (Preferred)