TriWest Healthcare Alliance

  • Project Manager - Claims Cust

    Recruiting Location Phoenix, AZ
    ID 2019-2698
  • Overview

    Work Location:  Phoenix, AZ

    Project Manager-Claims Customer Service at TriWest Healthcare Alliance

     

    Taking Care of Our Nation’s Veterans.

    It’s Who We Are. It’s What We Do.

     

    Do you have a passion for serving those who served?

     

    Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!

     

    Our job is to make sure that America’s heroes get connected to health care in the community.

     

    At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.

     

    Are you our next Project Manager-Claims Customer Service?

    Responsibilities

    TriWest Project Manager-Claims Customer Service:

    This position develops, analyzes, and coordinates Claims Customer Service projects and activities, including collaboration with subcontractor.  Conducts analysis and assessment of operational programs, processes and outcomes, develops and tracks metrics, produces management reports, and identifies process improvement opportunities. Collaborates with relevant departments, such as workforce management, training, quality, as well as sub-contractors to ensure cohesive interfaces across business systems while validating processes and changes are in alignment with TriWest business needs and business needs. . Participates in creation and maintenance of policies and procedures. Supports TriWest’s leadership with call center and industry best practice research.

    .

    • Researches Medicare and Veterans Affairs policies related to claims payments
    • Serves as subject matter expert resource to team members, supervisors, and other management teams
    • Performs medical claims review and analysis to improve quality and customer experience
    • Takes escalated claims customer service calls and conducts claims research
    • Collaborates with business units and subcontractors on identifying gaps in system interfaces
    • Produces and analyzes trend reports to identify root causes of errors, recommends solutions to management; implements solutions to processes
    • Creates reports, documents, and presentations, using Microsoft Excel, Word, PowerPoint and Visio for consumption by senior leadership
    • Coordinates, maintains, and recommends desk procedure process within Claims Customer Service teams
    • Works directly with department management, staff, and subcontractors to improve processes
    • Liaison to other departments coordinating needs for future training, quality, workforce scheduling, and new programs/processes as needed
    • Serves as point of contact for systems such as CRM or telephony, for maintenance, changes, and updates
    • Requires minimal supervision; models effective leadership skills; communicates effectively with other team members and Claims Leadership
    • Performs other duties as assigned
    • Regular and reliable attendance is required

    Qualifications

    Are you qualified?

    • Are you a Veteran, family member of a Veteran, a friend of a Veteran, or passionate about helping Veterans?
    • Do you have your High School diploma or G.E.D?
    • Do you have 3 years of healthcare claims experience, such as medical claims processing, medical office claims reconciliation, or healthcare operations?
    • Are you Proficient in written and oral communications and presentations?
    • Are you Intermediate to advanced Excel and Word skills
    • Do you have Leadership or project management experience?

    Preferred

    Do you have a Bachelor's (BS/BA) Degree in health care or related field
    3+ years of medical or Government claims processing experience?

    Do you have High volume call center experience?

    Do you have Business analyst, process improvement, or project management experience?

     

    More about Working at TriWest Healthcare Alliance

    We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

    • Medical, dental and vision coverage
    • Generous paid time off
    • 401(k) Retirement Savings Plan (with matching)
    • Short-term and long-term disability, basic life, and accidental death and dismemberment insurance 

    Equal Opportunity Employer

    TriWest Healthcare Alliance is an equal employment opportunity employer. All qualified applicants are considered for employment, without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic made unlawful by applicable federal, state, or local laws.

     

    Are you ready to make a difference in the lives of our nation’s heroes?

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