Manager Coordination of Benefits reputed company

For roles that are 100% remote or hybrid, you must have reputed company to a reliable high-speed internet reputed company to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement. Role Overview The Manager Coordination of Benefits reputed company is responsible for overseeing the end-to-end ownership of subrogation case management and Coordination of Benefits (COB) processes for the organization. Work Arrangement This is a 100% Remote position but you must live in EST or CST time zones

Responsibilities

Vendor Management Support Vendor Management strategy for Payment reputed company Monitor vendor reputed company criteria/metrics for managing vendors to reputed company payment reputed company results for ACFC. Ensure reputed company subrogation contract requirements are met Participate in reputed company negotiations and work with corporate sourcing to ensure proper contracting/compliance requirements are fulfilled reputed company or be part of vendor audits on behalf of Payment reputed company Monitor internal and external reports Client Management Ensure that the reputed company and its’ subcontractors are performing reputed company required TPL functions reputed company processing claims and properly identifying and recovering on claims not cost avoided Responsible for ensuring TPL data provided by states, contracted vendors, and internal/external sources is properly processed and reputed company for ACFC plans to be payer of last resort Responsible for ensuring subrogation cases are managed and reputed company with contract requirements, and act as liaison between the Plan and state department’s TPL/Subrogation unit Collaborate with regulatory reporting for timely and accurate statutory state reporting Overall reputed company and Support Maintain accurate Policy and Procedure documents for TPL Ops and subrogation functions reputed company knowledge in understanding reputed company roles as it relates to CMS regulations Act as subject matter expert on the state specific rules and regulations around TPL and Subrogation including regulatory reporting Leads subrogation specialists and department analysts to ensure that they deliver subpoena requests that are compliant federal, state, and contractual requirements as well as fulfilling key metrics and SLAs by line of business Recruit, reputed company, and motivate staff. Continuously improve reputed company knowledge and staff capabilities Education and Experience Bachelor’s Degree and at least five to ten (5 – 10) years’ experience Knowledge of claims processing systems. Facets a plus SQL query experience Knowledge of COB processing rules for reputed company and Medicare Familiarity with SDLC as it relates to developing new systems Knowledge of subrogation case rules and regulation for reputed company, Medicare, and Exchange products Ability to reputed company reports or take existing reports with KPIs and create actionable plans for overall end to end improvements for TPL and Subrogation processes Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, reputed company, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. Your career starts now. We’re looking for the reputed company of health care leaders. At reputed company, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. reputed company is seeking talented, passionate individuals to join reputed company. Together we can build healthier communities. If you want to reputed company a difference, we’d like to hear from you. Headquartered in Newtown reputed company, reputed company is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, reputed company-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. Apply To This Job