Claims Director

Claims Director
Position Code: 148

Department: Claims Administration
Location: Little Rock, Arkansas
Immediate Supervisor: Darren Ashby
Status: Exempt
Posted: June 26 2018

Essential Functions of Job:

• Hires and supervises unit that provides implementation and claims administration services to clients

• Achieves defined productivity, timeliness, and quality standards in claims administration
• Motivates, trains, develops and retains a competent claims processing staff
• Provides technical assistance on complex claims problems and benefit programming
• Interfaces with customers for new client installation and to resolve problems or determine satisfaction with claim service
• Develops and functions within a defined budget
• Proactively work with customers (both internal and/or external) to resolve problems and to provide unsurpassed customer service and seamless benefits administration
• Interface with new clients for implementation of group
• Assure system is programmed accurately to benefit design for each group
• Maintain assigned client documentation
• Maintain thorough understanding of client specific and industry standards
• Maintain active command of staffs’ job related skills
• Maintain claims accuracy and turn around time for all clients
• Some travel will be required
• Ability to report to the office
  
  Qualifications:
  
  • College degree preferred with emphasis in business administration, finance, management or mathematics. Experience considered in lieu of degree
• Effective organizational and prioritization skills
• Excellent oral and written communication skills
• Ability to work in a fast paced multi-tasking environment
• Advanced knowledge of Microsoft Office software applications (Word, Excel, Outlook, Access)
• Extensive claims management/ supervisory experience in a middle to large environment desired
• Knowledge of managed health care and utilization management preferred
• Capable of making effective demonstrations to potential clients
• Must possess excellent skills in benefit interpretation and have a thorough understanding of employee benefits
• Ability to recognize problems and implement effective corrective processes
• Excellent organizational and prioritization skills
• Working experience in a TPA environment a plus
• Minimum 5-10 years claims administration or equivalent experience preferred
• Keeps abreast of the current URAC Standards as they apply to this position
  
  The Company considers applicants without regard to race, color, national origin, sex, religion, mental or physical disability, marital status, age 40 years and over, sexual orientation or gender identity, veteran's status, or other characteristic protected by applicable law.
  
  Applications for this vacancy will be received for 3 working days after the Posted date from Employees of HealthSCOPE Benefits with more than one year of service.
  
  
  
  Applications for this vacancy will be received for 10 working days after the Posted date from External Applicants.