Director of Claims

Oversees the day to day operations/responsibilities of the Claims Department. Manages the Claims Managers, Supervisors, Trainers to ensure that they are educating, motivating and coaching their staff to meet the departmental/organizational goals and objectives. Attends committee meetings representing the Claims Department. Supervises the monthly reports for upper management regarding department activities. Assists with regulatory audit requests and ensures that policy and procedures are developed and implemented that meet the Plan and regulatory requirements. Conducts interviews and disciplinary actions on an as needed basis.
REQUIREMENTS
Five years experience in a management level position in a health insurance claims processing operation.
a minimum of three years experience in large HMO environment.
Five years in a user or liaison position involving the development and implementation of claims processing systems.
Four year college degree preferred.
Effective verbal written communication skills.