AVP of Claims Administration

NaphCare is hiring an AVP of Claims Administration to join our team at our Corporate Headquarters in Birmingham, AL.

*New grads are encouraged to apply - we'll train you in the exciting field of correctional healthcare!*

Provide strategic leadership and direction to the Director of Claims, Claims Managers and Claims team.
• Identify, analyze, recommend and implement process improvements in functional areas, including advancing claims processes, implementing automation, and enhancing servicing tools and analytics.
• Lead and oversee claims adjudication edits to prevent overpayments, fraud and compliance issues.
• Direct and manage credit balances resolution to identify overpayments and recover funds in a timely manner.
• Manage staff performance; implement strategies and plans to address staff development; identify and address training needs on an ongoing basis.
• Analyze reports and review internal audits to ensure benchmarks are met.
• Manage timecards, coordinate time off requests, and coverage.
• Appropriately communicate information both verbally and in writing to clients, team members, and executive management.
• Communicate with other departments as needed to ensure claims are processed accurately and timely.
• Train all new employees and coordinate ongoing training for current team members to ensure all NaphCare processes and job functions are followed.
• Delegate tasks to the team appropriately and provide support to the team members.
• Exhibit a high comfort level in working with large volumes of data.
• Demonstrate a strong attention to detail and a commitment to customer service throughout the eligibility process.
• Additional duties and specific projects as assigned.

• Bachelor's degree required.
• 5+ years Sr. Manager Business Operations.
• 5+ years supervisory/managerial experience in Revenue Cycle.
• Knowledge of Medicaid, Medicare and ACA programs.
• Strong leadership and training skills.
• Strong Human Resource skills.
• Strong follow-up skills.
• Excellence in Microsoft Office Suite and strong written and verbal communication skills required.

Physical Capabilities:

Must have the ability to stand for long periods, lift and move patients (up to 50 pounds), bend, squat, reach, push, pull, walk significant distances, and perform physically demanding tasks like CPR, all while maintaining good balance and endurance throughout a shift.

Why Join NaphCare?

NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US and we are growing. If you have never considered a career in correctional healthcare, now may be the time. In addition to competitive salaries and generous employee benefits, we strongly support career advancement within the company.

NaphCare Benefits for Full-Time Employees Include:

• Health, dental & vision insurance that starts day one!
• Prescriptions free of charge through our health plan, beginning day one!
• Lowest Cost Benefits!
• Employee Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays
• Free continuing education and CMEs

We know that you may have questions before applying - To inquire more on position information please email Human Resources and Talent Acquisition at Courtney.Herald@NaphCare.com

Equal Opportunity Employer: disability/veteran

Want a better idea of what it's like to work in a jail? See what our LPNs do:

NaphCare - Life as an LPN - YouTube

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