Description
Now Hiring:
Medical Claims Account Manager-Direct Hire
Location: Glastonbury, CT
Pay Rate: $85,000/yr
Schedule:
Monday-Friday 8:30am-5pm
Summary:
Delivers dedicated and loyal client service and provides oversight of the contractual agreements with specific clients such as state agencies, including departments of public health and insurance departments, program board of directors, and other contractually designated parties. Will perform administrative tasks related to client health premiums and medical out-of-pocket expenses, interact with clients to provide information in response to inquiries about products and services, handle and resolve complaints.
Duties and Responsibilities:
- Maintains overall knowledge of program, client's goals and requirements.
- Acts as a coordinator to assemble entire reports or responses to clients.
- Establishes strong positive client relationships.
- Provides timely response or follow-up to questions from both external and internal clients.
- Acts as primary point of contact and communicator with the client.
- Serves as group facilitator or meeting leader.
- Interacts with customer service team leaders, provides guidance on issues.
- Conducts quality assurance checks to ensure that SLAs are achieved.
- Reviews assigned contract on a monthly basis.
- Strong ability to read EOBs and healthcare terminology.
- Process or adjust medical insurance claims and appeals.
- Create and update financial batch records for processing by finance.
- Manage day-to-day workflow and promote teamwork.
- Identify, research, and resolve claim issues.
- Recommend process improvements.
- Medical Coding and Billing Certification or equivalent related experience.
- Previous experience as a supervisor or manager.
- Familiarity with medical claims clearinghouse.
- Bachelor's degree in Account Management, or five years of demonstrated experience in account management, or equivalent combination of education and experience.
- Project management, presentation, supervisory and leadership skills.
- High level of attention to detail.
- Excellent verbal and written communication skills.
- Ability to analyze, prioritize, and recognize when to escalate issues.
- Proven ability to manage multiple projects simultaneously.
- Entrepreneurial spirit, flexibility, and tolerance for ambiguity.
- Bilingual is a plus but not required.
- Ability to learn new data programs and applications.
Regularly required to sit, use hands, and talk or hear. Occasionally required to stand, walk, reach with hands and arms. Must occasionally lift/move up to 25 pounds. Specific vision abilities: close vision and distance vision.
Work Environment:
The noise level in the work environment is usually moderate. This is a wonderful opportunity to join a dedicated team and make a significant impact. Apply today to take the next step in your career as a Medical Claims Account Manager!
As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.
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