Medical Claims Manager - Indianapolis, IN

Claims Indianapolis, Indiana


  • Job Category:

    Claims

  • Location:

    Indianapolis, Indiana

  • Job Type:

    Permanent

  • Group:

    MIS Group/Medical Insurance

  • Number of Openings:

    1

Description

Position at Tokio Marine HCC

Medical Claims Manager – Indianapolis, IN


Every day, thousands of people travel the globe worry-free knowing that in case of a medical emergency they are covered and can rely on a dedicated team to help them. They rely on the people working at WorldTrips, a Tokio Marine HCC company.

We are looking for a Medical Claims Manager to join this energetic team in our Indianapolis, IN office.

This is a leadership position reporting into the VP of Operations and qualifies – after an initial onboarding period – as a position under our Dynamic Working policy to work from home one day a week.

What we offer

This is an exciting position in a growing part of the Tokio Marine HCC organization. WorldTrips is an ambitious organization offering a supportive environment where you are integral part of the team and its success.

What you do

You are responsible for managing the daily activities for the Claims personnel. This includes organizing staff to ensure full coverage during peak processing.

Relying on your broad experience and judgment, you are accountable for accomplishing the following responsibilities and have substantial latitude for actions or decisions made with minimal review.

  • Establish, monitor, and report on performance metrics around speed, accuracy, and quality of results.
  • Handle and resolve complex complaints or inquiries.
  • Manage vendor relationships.
  • Oversee cost containment activities to ensure appropriate level of cost savings is achieved.
  • Make recommendations on the settlement of claims and complaints.
  • Review departmental resources to ensure appropriate staff assignments are in place.
  • Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, and establishing personal networks.
  • Manage reporting and analysis of the departments, including production and performance statistics.
  • Improve performance by raising efficiency through process improvement or automation of repetitive tasks.
  • Develop the annual budget for the department and the ongoing management of budget variances.
  • Responsible for employee development and performance management. This includes ongoing coaching and mentoring of staff, annual performance evaluations, and daily issue resolution.
  • Act as a liaison with Human Resources in planning and developing staff recruitment.
  • Develop and maintain policies and procedures for the department, including periodic review of existing procedures to ensure all policies and procedures are current and effective.
  • Create and manage an efficient system for handling all types of incoming claims. This includes incoming member reimbursement claims and incoming provider direct-bill claims; as well as correspondence such as: provider appeals, member appeals, Departments of Insurance complaints, legal correspondence, and group inquiries.

 

What we look for

 - Minimum 4-year bachelor’s degree in business, a related field, or the equivalent education and/or experience. 
- 6 years relevant and progressive experience in area of claims specialization.
- 3 years Claims leadership experience.

And …

  • The ability to apply advanced knowledge of principles, practices, and procedures.
  • Excellent written and verbal communications skills with an emphasis on confidentiality, tact, and diplomacy.
  • Superior organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously.
  • Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company's business to proactively respond to changing business environment.
  • Advanced proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word).
  • Ability to analyze claim data to identify trends, manages backlog and pending claims, and communicates the results to senior management staff.

The Tokio Marine HCC Group of Companies offer a competitive salary and employee benefit package. We are a successful, dynamic organization experiencing rapid growth and are seeking an energetic and confident individual to join our team of professionals. The Tokio Marine HCC Group of Companies are equal-opportunity employers.

Please visit www.tokiomarinehcc.com for more information about our companies.

 Note: This document is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of all responsibilities, duties, and skills required for the job.

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