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Client Performance Manager - Liability
at Sedgwick CMS in Iowa
Client Performance Manager - Liability
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To be responsible for the quality aspects of a specific client including client service instructions and reserves; to conduct client specific audits; to monitor client audit compliance; to resolve client issues by working with the company Quality and Operations staff.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Ensures adherence to client service instructions.
Monitors client reserves for accurate reflection of client's book of claims; ensures reserves are within an appropriate range.
Tracks and trends performance guarantee and gain share agreements at the client level.
Ensures client's claims reports are properly and timely prepared and distributed.
Monitors client's average cost of claims; identifies trends and excessive cost factors.
Conducts client specific operational audits; monitors client audit compliance.
Works with company Quality and Operations staff to resolve client issues including results of client compas audits.
Manages client specific Internal Control Report issues.
Ensures timely payment of TTD, medical and vendor bills; ensures appropriate vendor utilization.
Reviews aging claims for file closure ensuring claims do not age beyond appropriate time frames.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred.
Experience
Five (5) years of claims management experience and two (2) years auditing experience required. One (1) year of continuous service with the company is required.
Skills & Knowledge
Thorough knowledge of claims management practices and procedures
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Leadership/management/motivational skills
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/20365553
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To be responsible for the quality aspects of a specific client including client service instructions and reserves; to conduct client specific audits; to monitor client audit compliance; to resolve client issues by working with the company Quality and Operations staff.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Ensures adherence to client service instructions.
Monitors client reserves for accurate reflection of client's book of claims; ensures reserves are within an appropriate range.
Tracks and trends performance guarantee and gain share agreements at the client level.
Ensures client's claims reports are properly and timely prepared and distributed.
Monitors client's average cost of claims; identifies trends and excessive cost factors.
Conducts client specific operational audits; monitors client audit compliance.
Works with company Quality and Operations staff to resolve client issues including results of client compas audits.
Manages client specific Internal Control Report issues.
Ensures timely payment of TTD, medical and vendor bills; ensures appropriate vendor utilization.
Reviews aging claims for file closure ensuring claims do not age beyond appropriate time frames.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred.
Experience
Five (5) years of claims management experience and two (2) years auditing experience required. One (1) year of continuous service with the company is required.
Skills & Knowledge
Thorough knowledge of claims management practices and procedures
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Leadership/management/motivational skills
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/20365553
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Published on Jul 06, 2011
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Viewed: 307 times
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