Lead, Core Operations (Remote)
Company: Molina Healthcare
Posted on: August 4, 2022
JOB DESCRIPTION Job Summary Responsible for administering claims
payments, maintaining claim records, and providing counsel to
claimants regarding coverage amount and benefit interpretation.
Monitors and controls backlog and workflow of claims. Ensures that
claims are settled in a timely fashion and in accordance with cost
control standards. KNOWLEDGE/SKILLS/ABILITIES
- Coordinates workflow and staffing of day-to-day activities as
well as assigns and monitors work of staff in order to adhere to
productivity and quality standards.
- Effectively manages escalations within the department by
ensuring appropriate accountability, sense of urgency,
communication and follow through to closure.
- Perform daily troubleshooting procedures to support enrollment,
disenrollment, claims, and claims support functions as needed.
- Participates in or leads quality improvement efforts to improve
claims processes and/or policies.
- Serve as subject matter expert and provide feedback to team
personnel and provide training as needed. JOB QUALIFICATIONS
Required Education Associate degree or equivalent combination of
education and experience Required Experience 5-7 years Preferred
Education Bachelor's Degree or equivalent combination of education
and experience Preferred Experience 7-9 years To all current Molina
employees: If you are interested in applying for this position,
please apply through the intranet job listing. Molina Healthcare
offers a competitive benefits and compensation package. Molina
Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Keywords: Molina Healthcare, Irvine , Lead, Core Operations (Remote), Other , Irvine, California
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