Provider Claims Process and Controls Manager Jobs

The Provider Claims Process and Controls Manager ensures that all claims are reviewed, settled, and processed in compliance with and according to contract provisions and regulatory requirements. Manages and implements corporate policy and process for medical provider and other reimbursements. Being a Provider Claims Process and Controls Manager requires a bachelor's degree of finance, business or healthcare administration. Evaluates and develops policies and provider reimbursement guidelines to effectively manage and control medical claims cost. In addition, Provider Claims Process and Control ... s Manager typically reports to head of a unit/department. The Provider Claims Process and Controls Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. Working as a Provider Claims Process and Controls Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. More
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