Act as point of contact for process related topics to line of businesses and COO.Ensure timely and accurate processing of claims and adjustments, managing performance to established metrics.Structure and deliver creative solutions while remaining practical, collaborating closely with functional leaders.Drive continuous improvement and ensure scalability of processes to support efficient business growth.Focus on accuracy and delivery cadence of reporting data and reports, address and/or escalate any issues with claim performance.Analyze, define and document key business processes and ensure all necessary staff is educated on workflows.Ensure end-to-end process of claims including claims platform, management of pending claims, EOB & EOPs harmonization and improvement, reviewing, documenting and where possible aligning best practices.Bachelor’s degree in a business, healthcare, or related fieldĮssential Job Functions And Responsibilities.15 years in insurance claims management.10 years in insurance claims management.Over the next several years this individual will be a key leader responsible for platform migration.
Streamline, harmonize and continuously improve processes, while building capabilities within the organization. This leader informs and educates teams on updated policies and requirements while ensuring high level of knowledge and service and works closely with the key operations leaders to Medicare and Federal Employee Program (FEP). This includes leadership and accountability of all claims activities for all lines of business including Commercial Group, Individual, The Staff Vice President of Claims is responsible for all management activities in claims, adjustments and EOB including, but not limited to, maintaining workflow processes, managing performance to established metrics and operational alignment. This work opportunity requires residency, and work to be performed, within the State of Arizona. BCBSAZ offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.
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