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Serves as first level of supervision for associates.Accountable for team performance measurements, associate and team development. Assists Manager in various team functions to include monthly scorecards, corrective action plans and staff communications.

PRIMARY RESPONSIBILITIES:
1.Manages the day-to-day activities of assigned associates; supervises staff creating development plans for associates, providing timely and effective feedback, and develops corrective action plans when performance is below standard documenting any and all performance-related activity.

2.Manages inventories, projects and backlogs to department standards for turnaround times.

3.Analyzes common reports specific to their assigned area.

4.Represents claims to internal and external customers.

5.Presents Process Improvement suggestions within assigned area.

6.Partners with Quality Assurance/Quality Improvement to understand root causes of errors made. Takes initiative to address and correct root causes of error.

7.Works with claims teams and other functional areas to ensure resolution to issues and provide long-term solutions.

8.Develops and mentors a high performance team, with high levels of productivity and quality.

9.Responsible for managing assigned area to Amerigroup and Department policies and procedures, as well as HIPAA regulations.

10.Create development plans for associates for management review.

11.Tracks productivity and performance of individuals; complete monthly scorecard for assigned individuals.

12.Supports departmental and corporate objectives.

13.Other duties as requested or assigned.

EDUCATION AND EXPERIENCE:

Education
Required:

• High School Diploma or GED

Preferred:

• College degree

Years and Type of Experience
Required:

• Minimum five years experience in medical claims processing or a related healthcare position,
• (External) Minimum of two years experience as a supervisor/team lead, or
• Demonstrated proficiency (1 year) as a Research Specialist or Subject Matter Expert.

Specific Technical Skills
Required:

• MS Office skills.
• Understanding of medical terminology claims coding, and standard claims forms used for physician and hospital billings.
• Analytical/Problem Solving Skills.
• Knowledge of state guidelines and regulations applicable to Medicaid.
• Knowledgeable of state guidelines, regulations and provider contracts specific to their assigned markets.

Preferred:

• Knowledge of Amerigroup markets and products.
• Understand core systems and processes of assigned area.

Certifications or Licensures
Required:

• (Internal Applicants) who do not possess a college degree, must have successfully completed the OD&T Online Training Courses in the Business Writing Series and OD&T Online Training: Peer Today, Boss Tomorrow prior to selection, or within their 90 day introductory period.
  Preferred:
• (Internal Applicants) OD&T Online Training Courses: Essentials of Management, Coaching & Team Building, Personal Communications.

Other:
Required:

• Basic understanding of expense management and cost controls.
• Conflict management skills.
• Possess strong interpersonal skills to manage, develop, and retain staff.
• Must be able to conduct, actively participate in meetings.
• Demonstrates initiative; is proactive in problem resolution; ability to multitask
• Able to work independently and use reference material to resolve claims related questions.

Preferred:

• Understanding of the interrelationships between Amerigroup departments to be able to communicate and interact effectively with associates and external customers.

SCOPE INFORMATION

1. Direct Reports: 20-25
2. Indirect Reports:
   Budgetary $ Responsibility:

PHYSICAL REQUIREMENTS:
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
• Ability to communicate both in person and/or by telephone.
• Must be able to operate a computer, telephone and fax machine
• Data entry using repetitive motion

Department: DSU – Long Term Care
Grade: 17
Recruiter: Lisa DiPiazza

AMERIGROUP administers pre-employment drug testing as a condition of employment and a satisfactory criminal history background report.

How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://amerigroup.contacthr.com/16554812