Emblem Health
Director, Claims Support (Finance)
Principal Accountabilities
Education, Training, Licenses, Certifications
• Bachelor's Degree
Relevant Work Experience, Knowledge, Skills, and Abilities
• 10+ years of claims management, analysis, audit and/or testing oversight experience
• Experience in staff and process management in positions with a history of increasing responsibility
• Prior health plan industry experience
• Deep and/or broad health plan functional, operational and technical domain expertise
• Experience in staff and process management in positions with a history of increasing responsibility
• Proficiency in Microsoft Office suite, including advanced Excel skills and MS Access
• Strong knowledge of claim processing, procedures and systems, State, Federal and Medicare Regulations
• Extensive knowledge of professional and facility claims processing systems
• Strong analytical and deductive evaluation skills to anticipate and resolve potential claim systems discrepancies
• Ability to identify issues, and to develop and propose effective solutions
• Effective communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences
• Excellent organizational and time management skills
• Deep and/or broad health plan functional, operational and technical domain expertise
• Proficiency in Microsoft Office suite, including advanced Excel skills and MS Access
Additional Information