Claims Processing Manager - CFHP

at University Health Systems

San Antonio, TX

Posted on Aug. 7, 2017


Full Time

Req. # 00061070
Location: Community First Health Plans
Department VP of Operations
Schedule: Full Time
Shift: Day Shift

Responsibilities:
• Manages and directs the activities of senior claim processors, medical claims processors and claims support staff.
• Rectifies and resolves escalated provider issues initiated by claim processors.
• Purveys written and telephonic resolutions for external customer issues (with both providers and members) in accordance with the health plan's policies and procedures.
• Develops claim procedure improvement methodology(s), directions and strategic plans for procedural improvement to support Community First Health Plans' (CFHP) business plan.

Education/Experience:
• Minimum of two years college level work in business, health care administration or a related area is required.
• Five years claims experience is required including two years at the management level.
• HMO claims experience is strongly preferred.

University Health System is one of the largest employers in San Antonio, with more than 6,000 employees and more than 800 physicians and residents. Many of our long-term employees could work anywhere, but choose us. And several employees gladly commute long distances for a rewarding career at University. Our Magnet designation for nursing excellence, our Level I Trauma Center and the teamwork approach in a teaching hospital environment prove that.

We are the future of healthcare, making a difference in the lives of our patients. Our advancement of medical knowledge through clinical research, our massive expansion and our ranking as one of the best hospitals in South Texas have created a critical need for the best, highly qualified individuals to join our team.

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