NaphCare has an excellent opportunity for a Claims Manager to join our Corporate Office in Birmingham, AL. This position will be under our Bureau of Prisons Department. This position is on-site at our offfice in Birmingham.

NaphCare is a family owned, medical technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 36 years.  Come join our team of over 7000 employees and growing!  NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do. 

Key responsibilities include and may not be limited to:

• Analyze reports and review internal audits to ensure benchmarks are met.
• Handle escalations with Claims team members, clients, and providers to ensure a resolution is achieved. 
• Appropriately communicate information both verbally and in writing to clients, team members, and supervisors.
• Communicate with other departments as needed to ensure claims are processed accurately and timely.
• Assist with training team members on client specific processes and payment methodologies.
• Delegate tasks to the team appropriately and provide support to the team members.
• Utilize medical terminology knowledge to review claims, medical records, and authorization scenarios.
• Exhibit a high comfort level in working with large volumes of data.
• Demonstrate a strong attention to detail and a commitment to customer service throughout the claims process.
• Work closely with the Director of Claims to ensure claims processes and systems are operating as expected.  
• Additional duties and specific projects as assigned.

• Associate's degree required
• 3+ years supervisory/managerial experience in medical claims adjudication
• 5+ years of medical claims processing
• Medicare/Medicaid claims processing experience preferred
• Knowledge of Medicare guidelines and payment methodologies
• Knowledge of medical terminology, ICD9, HCPCS and CPT coding, and an ability to understand medical records.
• Strong leadership and training skills
• Strong follow-up skills
• Proficiency in Microsoft Office Suite and strong written and verbal communication skills required.

Working Conditions:

• Office-based
• Ability to manage workload during peak appeals periods or regulatory deadlines

Why Join NaphCare?

NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US and we are growing. If you have never considered a career in correctional healthcare, now may be the time. In addition to competitive salaries and generous employee benefits, we strongly support career advancement within the company.

NaphCare Benefits for Full-Time Employees Include:

• Health, dental & vision insurance that starts day one!
• Prescriptions free of charge through our health plan, beginning day one!
• Lowest Cost Benefits!
• Employee Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays
• Free continuing education and CMEs

If you would like to speak with me to learn more about this position and NaphCare, apply directly to the position to initiate the application process, and I’ll be in touch.

Equal Opportunity Employer: disability/veteran

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The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with a job.