108 applicants

Company

Davies · 19 hours ago

Claims Director

USA

Full-time

Remote

Lead/Staff, Director/Executive

$60K/yr - $75K/yr

5+ years exp

Maximize your interview chances

Commercial InsuranceFinancial Services

Insider Connection @Davies

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

Consistent production of claim reports and findings

Maintain communication with clients and intermediaries on a regular basis for assigned accounts

Comfortable working solo or collaborating with clients, intermediaries, and peers.

Perform peer editing to validate the work of others

Assist with aspects of training

Knowledge of first dollar medical and pharmacy claims, claim processing platforms, and medical terminology and coding

Well versed in self-insured and managed care concepts

Knowledgeable of CMS regulations, Medicare fee schedules, Medicare programs, Medicaid fee schedules & Medicaid programs for state level agencies

Support company values of •We are Dynamic, We are Innovative, We are Connected, and We Succeed Together•

Perform other duties as assigned

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Medical claims experienceClaim processing platformsMedical terminologyCMS regulations knowledgeMicrosoft Office skillsMultitasking ability

Required

A minimum of 5+ years medical claims experience

Excellent written, verbal, and analytical skills and attention to detail is required

Strong Microsoft Office/Word/Excel skills required

Excellent communication skills

Superb organization and attention to detail skills

Ability to multitask in a fast-paced environment

Knowledge of first dollar medical and pharmacy claims, claim processing platforms, and medical terminology and coding

Well versed in self-insured and managed care concepts

Knowledgeable of CMS regulations, Medicare fee schedules, Medicare programs, Medicaid fee schedules & Medicaid programs for state level agencies

Benefits

Medical, dental, and vision plans to ensure your health and that of your family.

A 401k plan with employer matching to help you build a secure financial future.

Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.

Paid holidays.

Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.