VP / SVP Claims – Hybrid

Smith Arnold Partners
US - Connecticut - Stamford
June 3, 2024
Insurance

Hands on VP of Claims (Health Insurance/Managed Care) opportunity, responsible for leading the claims department and providing support and guidance while ensuring continual process improvements to better meet Company standards and contract obligations.
Ensures that department processes claims submitted for payment appropriately and timely.
Stable, rapidly growing business, marketable industry!
What people are saying:

'Very supportive work environment!'Good people, fun culture, challenging projects'Great environment for learning and skill development'Title:
Vice President, Claims (Health Insurance/Managed Care)
Location:
Stamford, CT HYBRID
Salary:
160,000 - 175,000 + BonusResponsibilities:

Operates as a subject matter expert, providing direction and thought leadership in all aspects of departmental operations
Responsible for leading the claims department and providing support and guidance while ensuring continual process improvements to better meet Company standards and contract obligations.
Responsible for direct supervision of Claims Manager/Supervisor, Claims Agents and Claims Assistant.
Carries out supervisory responsibilities in accordance with Company policies and applicable laws.
Provides leadership and direction to department which includes but is not limited to meeting productivity and service goals, identifying skill and resource gaps required for current and future work, and creating development plans
Drives and establishes operational and departmental objectives and goals
Advises senior management on strategic plans and ensures that all initiatives have clear business goals with approved return on investment
Fosters positive relationships with key business stakeholders (internal and external) by understanding business priorities
Reviews and advises department staff on complex claims
Monitors work queues, prioritizes claims and effectively delegates tasks to Claims Agents to ensure company standards and contract obligations are met
Reviews daily reports and monitors incoming and outgoing calls to ensure accuracy of output and identify user or system errors
Monitors, records and develops solutions for problems with the Authorization Tracking System (ATS), departmental workflows, telephone scripts, processes and procedures, and presents them at daily and weekly meeting for resolution.
Reports operational and technical issues with phone, fax, computer, etc.
to appropriate group and ensure problems are promptly resolved
Handles complex customer issues escalated by Claims Agents.
Coaches Claims Agents in troubleshooting routine as well as difficult customer issuesRequirements:

Bachelor's Degree in business-related field
Typically requires 10+ years of experience pertaining to claims departmental functions, Health Insurance/Managed Care industry
Typically requires 7+ years of experience leading and managing claims teams
Prior management experience overseeing large claims department
Medical terminology, CPT, and ICD coding experience extremely desirable
HIPAA experience useful
Ability to identify system issues and follow appropriate steps toward resolution
Business and management principles involved in strategic planning, resource allocation, leadership technique, production methods, and coordination of people and resources
Project planning and implementation

Read the full job description and apply online on the recuiter's web-site

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