$46.40-$56.43 Hourly / $8,043.00-$9,780.00 Monthly / $96,512.00-$117,364.00 Yearly
1. Assigns, supervises arid reviews the work of employees of the claims section of the health service system: interprets departmental rules, regulations and policies to employees; screens and processes medical claims and audits claims processed by subordinates.
2. Answers inquiries from health service members regarding their claims on major medical coverage or on other disputed claim matters or benefits; assists members in preparing major medical claims forms by advising them of the type of evidence required to submit claims.
3. Prepares correspondence relative to benefits, liability arid claims insurance subrogations.
4. Reviews medical claims processing methods and procedures and institutes and recommends changes to improve efficiency of operation.
5. Discusses medical claims or medical services with doctors, hospitals, laboratories arid others.
6. Prepares information releases regarding the health service system.
7. Appears before groups to explain various benefits and answer questions concerning medical claims activities and services.
Knowledge, Abilities and Skills: Requires considerable knowledge of: life, group, accident and health insurance; health, accident claims, compensation and disability evaluation; medical terminology.
Requires ability tot prepare clear, concise arid accurate reports; direct the work of others; deal courteously, effectively and tactfully with a variety of outside interests and groups.