LIBERTY Dental Plan Irvine, CA, USA
Oct 18, 2018
Job Description Fast-paced and rapidly-growing company seeks a National Claims Director . The Claims Director is responsible for directing the National Claims Operations, ensuring that quality and compliance standards are being met and the best possible service is being provided to our customers. Provides strategic leadership to National Claims Operations including long-term planning, technology strategy, and continuous improvement of operational efficiency. Oversee the day-to-day operations for the National Claims Operations. Supervise the development of workflows and procedures; identify and pursue needs for process improvements, quality auditing measures and system enhancements. Ability to successfully manage change and growth as well as juggle multiple and changing priorities with sometimes conflicting deadlines. Formulate and implement processes required to support corporate vision, goals and client service. Strive to improve service and efficiency. Develop new, improved, more accurate and efficient workflow processes. Balance productivity/quality requirements. Develop cost containment strategies to support the fiscal needs of the company. Confer with company leadership to discuss goals and objectives, to review progress, and to determine the needs to support corporate strategy. Prepare operation, productivity, and forecasting reports for management analysis. Establish, maintain and monitor goals of production and accuracy for each job function. Ensure we appropriately respond to correspondence regarding complaints, audits and inquiries that require management attention. Keep current on state and federal regulatory issues and industry activity and trends. Assist with various projects and initiatives. Complete all necessary tasks associated with managing direct reports in a timely fashion (e.g. time cards, performance reviews, holding timely one-on-one meetings, etc.). Education and/or Experience: 5 years’ experience directing/managing a Healthcare or Dental Plan Claims Department 7+ years’ experience in a managerial capacity Claims experience in a dental environment preferred Experience with claims regulatory/compliance requirements (DMHC, CMS, DOI, ERISA, NCCI, HIPAA regulations) Specific Skills/Knowledge: Strong leadership ability Excellent decision making and analytical skills Ability to manage multiple projects and heavy workload Broad knowledge of technology Strong communication skills Sponsorship and Relocation Specifications: LIBERTY Dental Plan is an Equal Opportunity Employer. No relocation assistance or sponsorship available at this time. Company Description Now serving over 3 million members nationwide, LIBERTY strives to provide the best customer service for not only our external customers, but our employees, who contribute to our success. LIBERTY puts people at the center of everything we do. We offer an environment where you can be challenged, pursue goals, develop and cultivate new skills. At LIBERTY, we are employee-focused and are committed to our people, their job satisfaction, their welfare, and of course, their safety.