POSITION SUMMARY/RESPONSIBILITIES

Acts as Claims Department resource to coordinate, analyze, and improve departmental performance. Identifies areas for improvement, documents business processes, researches best practices, compiles information and assists process owners to implement change and monitor performance. Responsible for providing project coordination through research, data collection and analysis to identify areas for increased operational efficiency, productivity and accuracy. Interacts with other CFHP departments. Helps ensure that systems, processes and reports enable the Claims Department to meet internal and external benchmarks.

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.