Careers
CHSI delives exceptional services to it members. One way we do this is with our people - highly engaged, smart, and talented individuals. If you could be interested in a career with CHSI, please call 888.529.1034.
Nevada Regional Claims Manager
Posted May 15, 2008
Position Location: Las Vegas, NV
Position Description and Responsibilities:
CHSI’s strength has been in customizing programs for high demand clients. The Manager must be capable of delivering a level of service and expertise which will surpass the expectations of our Clients. They must also be capable of conceptually developing programs and the implementation of those programs.
It is expected that the individual hired to this position will spend 60% of their time as follows:
Analysis of claims, medical, & pharmaceutical information
Development of financial & non-financial reports, charts, & graphs
Development of monthly summary reports to Boards
Development & monitoring of “key indicator” metrics for each mission critical area
Manage outside Service Providers (TPA, Medical Services, etc)
Manage direct reports at multiple locations
20% of their time as follows:
Provide internal education and training to CHSI Client Support Reps.
Provide one educational / training seminar monthly for clients and prospects.
Personalized service to Board Members and their requests.
Verbal & written follow-up with clients on all indemnity claims
Providing clients with claim control resources and education.
Working with the State on regulatory compliance items.
Assist in the coordination and management of Board meetings.
20% of their time as follows:
Conduct one on-site claims audit for each Mutual Benefit Corporation at the TPA’s office monthly. Reviews all medical records/documentation for medical necessity and appropriateness of care. Works with all parties involved in the management of the claim to formulate a plan for rapid, safe, and whenever possible, early return to work. Documents cost savings in a report to the Board.
Conduct on-going claim file reviews of all claims with a total value of >$15,000 monthly. Provide written summary and updates to clients.
Supervises bill repricing vendor, identifying issues related to bill flow, bill turnaround, duplicate billings, etc. and recommending changes/modifications/solutions to resolve identified problems/issues and ensures quality service.
Reading , researching, and keeping up to date and on top of changes in the industry.
Type your own documents, memos, letters, reports, etc.
Oversight of all “claims related” regulatory reports and filings.
Continually seeking to exceed client expectations by improving the levels of customer service to clients.
Overseeing multiple projects and expansion of new/existing services.
Developing, deploying, and institutionalizing new internal/external training and documentation processes.
CHSI of Nevada/California is a rapidly growing organization whose success is dependent on delivering superior service. It is critical that as the company grows, performance standards do not suffer. Growth will come not only through a larger customer base but also through expansion and leveraging of new services.
Our goal is to build a portfolio of lasting client relationships that will serve as a self-reinforcing track record. As our clients become more sophisticated, and as our relationship with them matures, this track record will be determined by one thing -- our ability to deliver on our promises of quality service and products.
To submit your resume and be considered for this position, please click here.
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