Claims Assistant Manager

WM MICHAEL STEMLER INC; Stockton (CA); Ibrido; USD 34.000 - 37.000; Tempo pieno

Descrizione del lavoro

WM MICHAEL STEMLER INC. is seeking a capable claims/management professional for a Full Time role based in Stockton with remote capabilities. You will supervise staff, coordinate training, respond to inquiries, manage workflows, and ensure compliance with health insurance claims policies and regulations.

The position requires 2–4 years of management and claims experience, strong computer skills, excellent communication, and leadership abilities. Travel to client locations may be required.

Competenze

• Two to four years of management and claims experience.
• Proficient in spreadsheet and word processing applications.

Mansioni

• Assist with the supervision of staff, including training, planning, and directing work.
• Respond to staff and customer inquiries; provide resolutions.
• First point of contact for client calls requiring research and response.
• Manage assigned tasks, queues, and ensure inventory is handled per department guidelines.
• Handle internal emails, track inventory, and collaborate with staff for timely responses.
• Collaborate with reporting manager to meet turnaround times and quality standards.
• Identify training needs; work with QA on unit module updates.
• Attend staff meetings to assist with delivery of materials, trainings, and communication.
• Coordinate workflow and control of work procedures; guide subordinates on general claims.
• Directly communicate with clients, providers, and internal/external areas.
• Adhere to company and department policies and timeliness guidelines.
• Occasional travel to client locations.
• Performs other duties as assigned.

Conoscenze

Leadership

Claims management

Customer service

Communication

Inventory management

Descrizione del lavoro

Job Details:

Job Location: DHS Remote - Stockton, CA 95219, Position Type: Full Time, Salary Range: $25.00 - $27.00 Hourly, Job Category: Management,

• Assist with the supervision of staff specific but not limited to training, planning, and directing work.
• Responds to staff, internal and external customer inquiries, and provides resolution to issues accordingly.
• First point of contact for customer calls that require research and a response.
• Manages assigned tasks, queues, and ensures inventory is handled within department guidelines.
• Manages internal emails, tracks inventory, and collaboration with staff for timely responses within department guidelines.
• Collaborate with reporting manager to ensure turn-around times, quality standards and company goals are met.
• Trend errors for assignments, identify training needs for staff, collaborate with quality assurance on unit module updates.
• Attends staff meetings to assist with delivery of materials, trainings, and communication.
• Assists in the coordination of the work flow and control of work procedures.
• Provides guidance to subordinates regarding general claims and escalated issues.
• Communicates directly with clients, providers, and internal and external areas.
• Adherence to company and department policies and procedures.
• Understands the guidelines for timeliness and the expected turnaround time within the department.
• Must occasionally travel to client locations.
• Performs other duties as assigned.

Qualifications:

• Two to four years of management and claims experience.
• Must be computer literate w/proficiency in spreadsheet and word processing applications.
• Excellent written and verbal communication skills.
• Must have excellent leadership abilities and interpersonal skills; ability to establish confidence, rapport and foster cooperative relationships with clients, providers, and co-workers.
• Must understand self-funded payer claims policies as well as Federal, State and other regulations pertaining to health insurance claims payment including TPL, COB, and coding and reimbursement methodologies.
• Experience with automated claims systems; and ability to maintain sound production operations also required.

Supervision:

This position reports directly to a Stockton Claims Manager, limited supervision with considerable responsibility for work quality and quantity