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Claims Director of Provider Disputes

Remote: 
Hybrid
Contract: 
Salary: 
116 - 145K yearly
Experience: 
Senior (5-10 years)
Work from: 
Montebello (US)

Offer summary

Qualifications:

Bachelor's degree or equivalent required., Minimum of 6 years leadership experience., Experience in managed care Health Care Claims., Strong understanding of regulatory compliance..

Key responsabilities:

  • Oversee all aspects of claims operations.
  • Lead teams for performance management and quality improvements.
AltaMed Health Services Corporation logo
AltaMed Health Services Corporation Large http://www.AltaMed.org
1001 - 5000 Employees
See more AltaMed Health Services Corporation offers

Job description

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Job Overview

The Claims Director of Provider Disputes and Resolution has overall responsibility and accountability for all aspects of the claims operation for all Provider Disputes, provider projects, as well as provider refund recoveries. Within this role, the Director will ensure to meet regulatory compliance as well as company objectives as they relate to the resolution of the provider issue. The Director is responsible for leading and supporting each unit while being accountable for performance management, quality improvements and operational accuracy. The Director will leverage experience and integrate various components of cross-functional business decisions to continuously improve claims’ processes and procedures. This position will participate in various forums, company initiatives, and other internal/external workgroups to support Claims integrity. Directs all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.

Minimum Requirements

  • Bachelor’s degree or equivalent required.

  • Minimum of 6 years of progressive leadership experience in the areas of managed care Health Care Claims required.

Compensation

$116,075.66 - $145,094.58 annually

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

  • Medical, Dental and Vision insurance
  • 403(b) Retirement savings plans with employer matching contributions
  • Flexible Spending Accounts
  • Commuter Flexible Spending
  • Career Advancement & Development opportunities
  • Paid Time Off & Holidays
  • Paid CME Days 
  • Malpractice insurance and tail coverage
  • Tuition Reimbursement Program
  • Corporate Employee Discounts
  • Employee Referral Bonus Program
  • Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Required profile

Experience

Level of experience: Senior (5-10 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Training And Development
  • Coaching
  • Self-Motivation
  • Supervision

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