October 29, 2011 (last updated 21 hours 24 min ago)
Solid reputation, passionate people and endless opportunities. That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.
SUMMARY: This position is responsible for providing direction and leadership to a team comprised of medical and surgical provider appeal analysts. Ensuring accuracy and timeliness of reviewing and analyzing appeals. Selecting and training staff. Initiating all human resources actions (performance management, performance assessments and ratings, salary & rewards and recognition administration, etc.) PRIMARY DUTIES: Establish, monitor and deliver individual team goals based on overall office Service Level Agreement (SLA) Coordinate work activities to ensure appropriate deployment of resources to maximize productivity and ensure highest level of service Motivate team members by providing training, honest constructive performance feedback and counseling. Ensure proper bill review handling techniques are utilized to provide consistent quality. Good working knowledge of all areas of Appeals. Monitor new medical bill issues and billing trends and report to next level management. Research and report system issues. Work with next level management to establish and implement staffing strategy. Implement strategies and initiatives to improve appeals review quality and productivity. Using multiple screens on the Medical Bill Re-pricing System to investigate and resolve escalated provider calls and medical appeals Create and deliver performance reviews Coach, monitor and facilitate the development of team members to maximize individual and organization performance Evaluate and manage performance objectives relative to quality, productivity & other office standards/goals as well as providing individual team feedback on an ongoing basis Recognize all factors of performance, business results & personal effectiveness EDUCATION/COURSE OF STUDY: Bachelors degree preferred and /or equivalent work experience WORK EXPERIENCE: Proven ability to lead a team of analysts in a high quality/ high production environment. Certified Coder preferred or commensurate experience with the following resource materials; Current Procedural Terminology, International Classification of Diseases-9 Revision, Healthcare Common Procedural Coding System- 9th Revision, itemized hospital bills and other hospital records. Certified California Medical Bill Reviewer a plus. Knowledge of Workers Compensation claim process and procedures, preferred. Good working knowledge of human anatomy and medical terminology preferred. Strong interpersonal communication skills. Excellent verbal and written communication skills, including effective sentence construction, grammar, spelling, and punctuation. Solid math skills - must be able to quickly and accurately add, subtract, multiply and divide with the assistance of a calculator. Basic computer skills - ability to toggle between screens to find data that is needed to process medical bills and working knowledge of Microsoft Office products (e.g. Excel, Power Point, Word, Outlook). Ability to understand business drivers and effectively communicate business decisions.
OTHER: Good leadership skills. Strong analytical skills Ability to perform and be flexible in a high production environment Ability to handle multiple tasks. Superior Organizational Skills and Attention to Detail Commitment to Task Continuous Learning Strong decision making and problem solving skills. Ability to think issues through to conclusion, weighing the benefits and risks effectively. Sense of urgency Ability to deliver performance objectives in a timely manner. Travelers is an equal opportunity employer. We actively promote a drug-free workplace.
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