Claims Review Manager: Lead Medical Authorizations & Claims

NaphCare, Inc.; Birmingham (AL); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Health, dental & vision insurance

401k with company contribution

Tuition Assistance

Paid time off

Continuing education

CMEs

Job summary

NaphCare, Inc. is seeking a Claims Review Manager at our Corporate Headquarters in Birmingham, AL.

The role oversees a team of claims specialists who review medical authorizations and reconcile claims, serving as a liaison between scheduling and claims to ensure timely processing and accuracy. The ideal candidate has a minimum of three years in healthcare claims, billing, or medical authorization, strong Excel skills, and the ability to manage high-volume workloads with attention to detail while

Qualifications

• Three (3) years minimum experience in a healthcare claims, billing or medical authorization setting.
• Strong written, verbal and organizational skills.
• Ability to prioritize, delegate, and meet deadlines in a high-volume environment.
• Working knowledge of medical claims, medical terminology, medical records, and medical authorization processes.
• Proficiency with Microsoft Office, especially Excel.

Responsibilities

• Oversee a team of claims review specialists and ensure timely, accurate processing of authorizations and claims.
• Develop and deliver regular reports on team analytics and KPIs.
• Identify and implement improvements to processes and workflows to increase efficiency and accuracy.
• Maintain confidentiality of medical records and patient data.
• Serve as a liaison between scheduling and claims to facilitate timely processing.

Skills

Healthcare claims experience

Team leadership

Data management

Attention to detail

Communication skills

Education

Healthcare administration field degree preferred

Associate's or Bachelor's degree

Tools

Microsoft Office Suite

Excel

Job description

NaphCare, Inc. is seeking a Claims Review Manager at our Corporate Headquarters in Birmingham, AL.

The role oversees a team of claims specialists who review medical authorizations and reconcile claims, serving as a liaison between scheduling and claims to ensure timely processing and accuracy. The ideal candidate has a minimum of three years in healthcare claims, billing, or medical authorization, strong Excel skills, and the ability to manage high-volume workloads with attention to detail while