Related skills
kpi data analytics claims processing sla claims adjudication📋 Description
- Oversee, mentor, and evaluate claims examiners at all levels; monitor KPIs.
- Lead claims processing and inventory management for timely adjudication.
- Analyze quality findings to identify root causes of errors.
- Identify gaps and implement improvements in claims processing.
- Act as escalation point for complex claims; drive investigations and solutions.
- Prepare reports and partner with Data Analytics to hit KPIs and SLAs.
🎯 Requirements
- Dedication and passion for helping people navigate health insurance.
- Strong knowledge of medical terminology, CPT/ICD codes, and adjudication.
- Familiarity with state/federal healthcare laws and regulations.
- Proven ability to motivate, train, and evaluate staff to meet SLAs.
- Experience leading and managing claims examiners with feedback.
- Proven success leading projects with impactful results.
🎁 Benefits
- Salary: $59,250-$98,750 USD per year.
- Health/wellness, PTO, parental leave, holidays, 401k.
- Paid paw-ternity leave.
Meet JobCopilot: Your Personal AI Job Hunter
Automatically Apply to Operations Jobs. Just set your
preferences and Job Copilot will do the rest — finding, filtering, and applying while you focus on what matters.
Help us maintain the quality of jobs posted on Empllo!
Is this position not a remote job?
Let us know!