Copyright 2023 Cook Children's Health Care System, Fort Worth, Texas
Position is responsible for managing the personnel and processes of the Claims Processing team. Primary duties include, but are not limited to: 1. Managing the claims inventory and turn-around time in compliance with State contract requirements 2. Hire, train coach and evaluate performance of direct reports 3. Track and report staff metrics to leadership 4. Perform and/or coordinate claims research related to claim issues 5. Develop strategies to maximize auto adjudication and reduce adjustments and appeals 6. Establish and maintain comprehensive departmental policies and procedures 7. Perform audits to monitor efficiency and compliance with policies 8. Professionally communicate and collaborate across all functional areas of the Health Plan
Education & Experience
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.