What are the responsibilities and job description for the Health Claims Audit Manager position at Amwins?
Join Our Team as a Claims Quality Assurance Manager at Stealth Partner Group, an Amwins Group Company!
Stealth Partner Group, an Amwins Group Company, seeks an ambitious Health Claims Audit Manager passionate about maintaining and growing our organization. This role oversees the Claims Department's quality assessment program, develops, and implements quality measures, and manages functional roles supporting these initiatives. Reporting to the Senior Director of Claims, the Claims Quality Assurance Manager plays a critical role in ensuring high performance and efficiency within the department.
This an in-office position, that offers the flexibility to work from home up to 2 days a week after completing training. Please note, that as a leader, you may be expected to be in office more frequently to support hiring, training, and business operations activities.
Why Choose Amwins?
At Amwins, we value our team members and offer a range of benefits to enhance your work experience:
Key Responsibilities
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Stealth Partner Group, an Amwins Group Company, seeks an ambitious Health Claims Audit Manager passionate about maintaining and growing our organization. This role oversees the Claims Department's quality assessment program, develops, and implements quality measures, and manages functional roles supporting these initiatives. Reporting to the Senior Director of Claims, the Claims Quality Assurance Manager plays a critical role in ensuring high performance and efficiency within the department.
This an in-office position, that offers the flexibility to work from home up to 2 days a week after completing training. Please note, that as a leader, you may be expected to be in office more frequently to support hiring, training, and business operations activities.
Why Choose Amwins?
At Amwins, we value our team members and offer a range of benefits to enhance your work experience:
- Flexibility: Enjoy a hybrid work environment with flexible scheduling options.
- Comprehensive Benefits: Access a competitive benefits package from day one, including generous Paid Time Off (PTO) and paid holidays.
- Continual Learning: Thrive in a collaborative, education-focused work environment.
- Annual Bonus Program: Earn rewards through our bonus program after just one year of employment.
Key Responsibilities
- Oversee operations and performance of roles including Aggregate Specialist, Closing Specialist, and Claims Reporting Analysts.
- Develop and implement department-wide quality measures.
- Manage all audit programs within functional roles and independent audit programs such as the Dollar Limit Release audit.
- Oversee closing activities by Closing Specialists to ensure accuracy and timeliness.
- Manage Reporting Specialist activities, implementing audit controls for quality and consistency in monthly reporting.
- Produce monthly aggregate activities reports from Aggregate Specialists.
- Assist in developing and implementing policies and procedures for efficient Claims operations.
- Collaborate with Claims Management for effective service delivery.
- Build positive, collaborative relationships with internal departments and external clients.
- Assist in developing and implementing training programs to meet quality standards.
- Perform other duties and projects as assigned.
- Minimum 3-5 years of Quality Assurance experience with progressive responsibilities and/or Six Sigma Quality Control knowledge
- Experience in a Claims production environment is required
- Bachelor's degree in a related field or 3-5 years of work experience in Stop Loss, Ancillary, or TPA environment (preferred but not required)
- 3-5 years of management experience preferred
- Proficient in Microsoft Office (Word, Excel, Outlook, etc.)
- Proven ability to manage time effectively, prioritize workload, and meet deadlines
- Strong teamwork skills: ability to work cooperatively and jointly with various staff members
- Strong organizational and multi-tasking skills
- Excellent written and verbal communication skills
- Sense of urgency and attention to detail are essential
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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