Job Description:
Summary:
This position oversees the Reimbursement Claims Processing Team that is responsible for the facilitation, processing, and substantiating all claims associated with the Departmental Product Portfolio including: Flexible Spending Accounts (FSA), Health Reimbursement Arrangements (HRA), Health Savings Accounts (HSA), Transit and Parking, Student Loan, Tuition Reimbursement, and Wellness Benefits.
Essential Accountabilities:
- Manages and oversees the daily activities of the claims processing team. This includes, but is not limited to hiring, onboarding, training, performance appraisals, facilitating team meetings, employee development, administration of company policies, and team recommendations.
- Plans, coordinates, prioritizes, monitors, and reports on activities related to assigned personnel. Evaluates workflow and inventory levels to ensure production and timely completion according to performance standards and regulatory requirements.
- Develops, implements, and monitors the claims operations in terms of workflows, performance metrics, internal audits, policies and procedures for effectiveness, efficiency, and compliance. Continuously works to identify and remove barriers to increased productivity, quality, cost effectiveness, and timeliness of claims operations and member satisfaction.
- Reports and addresses backlogs or inventory concerns with management; identifies processing problems and implements solutions through process improvement initiatives.
- Leads system enhancements, release testing and process improvement projects, as well as other special projects assigned by the department management.
- Provides direct client/broker/member support as necessary — special projects, audits, education and training, troubleshooting, problem resolution, etc.
- Ensures that LBS policies comply with applicable laws and corporate personnel policies.
- Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
- Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
- Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are compliant with these requirements.
- Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information.
- Regular and reliable attendance is expected and required.
- Performs other functions as assigned by management.
Minimum Qualifications:
- Five or more years of related work experience, three or more of which in healthcare or reimbursement claims processing operations.
- Prior experience supervising or managing people and/or projects or indirectly leading teams.
- Thorough ongoing knowledge and application of IRC Sections (e.g., 105, 125, and 129) regulations/ compliance that apply to benefit administration.
- Ability to make prudent and critical decisions that are well researched and reflect awareness of the impact on the department and the Company.
- Good organizational skills and ability to prioritize assignments.
- Ability to establish and maintain constructive working relationships with all levels of internal personnel as well as external constituents.
- Intermediate to advanced Excel skills preferred. Additionally, general PC skills including but not limited Microsoft Outlook and Word.
Physical Requirements:
- Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer.
- Ability to travel across the Health Plan service region for meetings and/or trainings as needed.
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In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
Compensation Range(s):
Minimum: $65,346 - Maximum: $117,622
The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.
Please note: There may be opportunities for remote work on all jobs posted by the LBS Recruitment team. This decision is made on a case-by-case basis.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.