Lead, Core Operations (Claims) - REMOTE
Passport Health Plan by Molina Healthcare Louisville, Kentucky; Georgetown, Kentucky; Florence, Kentucky; Owensboro, Kentucky; Lexington-Fayette, Kentucky; Covington, Kentucky; Richmond, Kentucky; Bowling Green, Kentucky; Nicholasville, Kentucky Job ID 2027312Passport Health Plan by Molina Healthcare has a mission to provide quality health care to those who need it, no matter their circumstances. Today, Molina health plans serve 3,331,000 members across the country through government-funded programs. Each day, we work to earn the trust our partners and members put in us, so they can lean on Molina. Together, Passport Health Plan and Molina share a commitment to improving the health and quality of life of our members across the Commonwealth of Kentucky.
- Full Time, Part Time
- Level: All Levels
- Travel: Occassional
-
Success Profile
What makes you successful at Passport Health Plan by Molina Healthcare? Check out the traits we’re looking for and see if you're the right fit!
- Compassionate
- Consultive
- Patient
- Problem-Solver
- Sincere
- Relationship Expertise
Benefits
-
Insurance
Medical · Dental · Vision
Group & Voluntary Life Insurance
Aflac · Pet Health · Identity Theft
Auto & Home Insurance -
Savings
Flexible Spending Accounts
401K · Roth 401K
Employee Stock Purchase Plan -
Career Growth
Continuing Education Units
Education Reimbursement -
Time Off
Paid Time Off
Volunteer Time Off
Company Holidays -
Additional Perks
Legal Assistance Plan
Employee Assistance & Well Being Programs
Employee Perks Platform
Rideshare Portal
Responsibilities
JOB DESCRIPTION
Job Summary
Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.
KNOWLEDGE/SKILLS/ABILITIES
- Coordinates workflow and staffing of day-to-day activities as well as assigns and monitors work of staff in order to adhere to productivity and quality standards.
- Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
- Perform daily troubleshooting procedures to support enrollment, disenrollment, claims, and claims support functions as needed.
- Participates in or leads quality improvement efforts to improve claims processes and/or policies.
- Serve as subject matter expert and provide feedback to team personnel and provide training as needed.
JOB QUALIFICATIONS
Required Education
Associate degree or equivalent combination of education and experience
Required Experience
5-7 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
7-9 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $14.76 - $31.97 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 08/26/2024ABOUT OUR LOCATION
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