Medical Claims Professionals (Leadership positions in San Ramon, California

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Are you a skilled Medical Claims Expert?
We are looking to load multiple leadership positions in our claims department. We offer fantastic growth capacity, a competitive wage, and lasting career security.
Positions Readily available:.
Cases Supervisor (Conformity & & High quality)
. Claims Manager (Operation & & Quality).
Claims Fitness instructor (Classroom training needed).
Experience/Skills needed:.
We are looking for skilled claims specialists with a minimum of 3 years in Claims Handling and 3-7 years in a management function (Lead, Manager, Trainer, Supervisor etc.).
Recognize, examine, and reply to division trends, solve solution, operational, and management concerns.
Know-how of cases refining fundamentals is a need including all facets linked with passing all health plan/regulatory requirements for all plan audits; liable for audit results and restorative activity plans where relevant.
Solid working knowledge of Medi-Cal, DMHC, CMS and Health insurance demands and the ability to practice and enhance understanding of staff as health insurance and regulatory physical bodies demands transform.
Make sure the divisions auditing procedures consisting of customer support demands, records, unique tasks, and concentrate audits are completed routinely to check quality.
Should be able to nurture a good team environment and assistance mutual responsibility and duty.
Manager:.
 Create and prepare spending plans that call for complex solutions to establish staffing evaluations; capability to handle spending plans in excess of $1 million with a direct staff of 4-6 and an indirect personnel of 30.
Create department expectations that are in line with our ability to satisfy and surpass all corporate assumptions consisting of all regulatory demands.
Manager:.
 Create action strategies based upon audit benefits and assist the claims management group in the perpetuation and assessment process within the division in order to boost top quality.
Screen specific team performance and give coaching/feedback regularly, conduct timely efficiency examinations, conduct huddle conferences and training as proper.
Instructor:.
Minimum of 4 years of experience in training, training administration or business advancement, including 2 years of previous training at a health insurance or IPA.
Establish and motivate cases processors to accomplish their highest possibility, and serve as a mentor for all cases processors during the training program.


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