Claims Processing Manager at National Vision Administrators

Free Form Minds has been retained to conduct this search on behalf of Benecard Services and National Vision Administrators. Please fill out application questions to be considered.

Are you detail-oriented and deadline-driven? Do you want to grow as a leader? Do you have experience with processing insurance claims?

Come join our family at NVA!

NVA, (National Vision Administrators), is seeking a new Claims Processing Manager to join the Director, Claims and Auditing in supervising a team of 7 Data Entry Operators. The team works in-person in Clifton, New Jersey. It is an exciting time to join the team as they build out their auditing system. This role is full-time, exempt, and benefitted, with access to professional development and opportunities for growth and continued learning and development.

Read below for information on responsibilities, requirements, benefits, and how to apply. Please contact Free Form Minds representative: Jessye Kass, with any questions.

Job Responsibilities

• Prepare all audit documents with a detail-oriented and organized approach.
• Supervise and delegate daily work to a team of 7 Data Entry Operators. Provide thoughtful and engaging leadership that addresses individual team members who are unionized.
• Process all claims that require supervisory override.
• Conduct necessary research for rejected claims and provide remittance advice.
• Meet monthly department goals and prompt pay deadlines.
• Create, review, and deliver monthly reporting on status of claims and pending projects.
• Work closely with the Director, as a thought partner, in managing the team, Medicaid and Medicare priorities, multiple deadlines, and increases in claims.
• Promptly and efficiently respond to communications.
• Effectively utilize software, tools and knowledge acquired from training.
• Commitment to, and interest in, meeting or exceeding claims metrics, while providing consistently excellent claims processing.
• Participate in onboarding training, as well as other training and learning opportunities to expand knowledge of the company and our position in the industry.
• Adhere to all company policies and procedures.

Requirements:

• 5 years of experience processing and adjudicating Medicaid and Medicare claims.
• Experience with 6 or more of the following:
• Billing and Coding Edits (CPT/ICD-10/HCPCS/ Modifiers)
• Third Party Liability COB (Coordination of Benefits) filing rules
• CPT Codes/HCPCS Codes
• Electronic billing processes and universal billing forms (HCFA 1500)
• Proper use of modifiers with procedure codes
• Knowledge of the appeal process to government payers
• Strong understanding of the billing resubmission process.
• 1-2 years of experiencing supervising employees.
• Commitment to timely filing, researching rejected claims, and providing remittance advice.
• Computer proficiency in a Windows environment, knowledge of Microsoft Office products, and a strong proficiency in Excel (expertise in Excel a plus)

Qualifications that are highly desirable:

• Professional Coder (CBC) and/or Certified Professional Biller (CPB) a huge plus.
• Knowledge of AS400, or other comparable software systems and an aptitude and curiosity for learning new software.

Claims Manager Characteristics:

• Excellent attention to detail.
• Strong leadership experience or capacity, with an interest in growing as a leader.
• Analytical approach to problem-solving and interest in constant problem-solving.
• Excel at time management and delegation.
• Ability to communicate effectively with team members, supervisor, other departments, and external partners.
• Organized, efficient workstyle with the capacity to plan and prioritize.
• Fast learner with ability to retain information and stay updated and informed on company products, services, and policies.
• Positive attitude and capacity to maintain professionalism at work.
• Adaptable learner with self-awareness on learning styles and needs.

Benefits

• Salary range for this role is $60,000- $70,000 (annualized base salary incentive earnings merit increases)
• This is a full-time, exempt role, in-person in Clifton, New Jersey.
• 10 days of paid vacation, 5 personal days, 9 paid holidays, comp day on your birthday, 3 days of bereavement leave (for immediate family), and paid family leave.
• A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with a match after 1 year of employment.
• Stable, consistent workplace with a family-like work community, committed to opportunities for coaching, training, support and growth.

How to Apply:

We have retained Free Form Minds for this search. Please submit answers to the application questions to be considered for the role.

If you have any accessibility issues or questions, you may contact Jessye Kass,

Application Questions:

Answering these questions is required to be considered for the role.

• What interests you in this role and why would you be a great selection for the next Claims Manager?
• Describe your approach to supervising a team of employees. How do you delegate tasks effectively while maintaining team morale?
• How do you stay updated on changes in Medicaid and Medicare billing regulations and procedures? Can you give an example of how you applied this knowledge to improve claims processing efficiency or accuracy?

Job Type: Full-time

Pay: $60,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Parental leave
• Professional development assistance
• Retirement plan
• Vision insurance

Compensation package:

• Bonus opportunities
• Performance bonus

Schedule:

• Monday to Friday

Work setting:

• In-person
• Office

Application Question(s):

• REQUIRED: What interests you in this role and why would you be a great selection for the next Claims Manager?
• REQUIRED: Describe your approach to supervising a team of employees. How do you delegate tasks effectively while maintaining team morale?
• REQUIRED: How do you stay updated on changes in Medicaid and Medicare billing regulations and procedures? Can you give an example of how you applied this knowledge to improve claims processing efficiency or accuracy?
• OPTIONAL: Is there anything else you would like us to know about your candidacy, gaps of employment, or anything that will help us understand you better?

Ability to Commute:

• Clifton, NJ 07013 (Required)

Work Location: In person