POSITION SUMMARY/RESPONSIBILITIES

Supervises, assists, and directs the activities of the assigned claims processing unit and the assigned staff. Responds to issues escalated through the claim examiners. Provides solutions to problems in accordance with CFHP policies and procedures. Plans and implements methods to improve work procedures and areas.

EDUCATION/EXPERIENCE

High school diploma required. Five (5) years claims experience is required. One to two (1-2) years supervisory experience preferred. Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years’ experience project coordination in a managed care environment is preferred. Proficiency in Word, Excel, and Powerpoint, is required.