Manager, Claims Services

Plan, prioritize, coordinate and monitor activities in the department to ensure accurate, timely and efficient service. Manage, train and evaluate staff to achieve and maintain department standards. Develop and deliver programs that support business needs.

Lead projects for the division from inception to completion

Develop and maintain strategic partnerships with VSP Division Management Teams; provide business partners and key executives with customer perspective and facilitate timely response to complex business challenges and opportunities

Recommend and implement procedural and systems changes to deliver quality service to internal and external customers

Facilitate change in VSP processes, procedures, and systems within the Customer Service Division; develop and implement communication strategies that support VSP and the division's Mission, Vision, Value, and Goals

Ensure effective communication is maintained within the division and externally.  Where appropriate, inform employees as to plans and programs; conduct employee discussion sessions at regular intervals

Prioritize, assign, and distribute work to ensure responsibility is at the appropriate level and team member’s skills are developed to support business needs

Identify, consolidate, and prioritize training needs and coordinate training programs with the training unit

Monitor turnover, productivity, and overall performance to ensure adequate staffing and performance that meets department standards

Assist in the development of the division budget. Monitor expenses to ensure costs are within established levels

Identify and support opportunities for process improvements, resulting in cost efficiencies

Coordinate with other units/departments to facilitate special requests, coordinate tasks, and resolve escalated issues

Job Specifications

Typically has the following skills or abilities:

Bachelor’s degree in related field or equivalent experience

Minimum of 3 years of management experience with responsibilities for hiring, training, assigning work, and managing performance of direct reports

Working knowledge of Claim systems, business processes, and policies and procedures

Knowledge of quality performance monitoring and improvement methods

Demonstrated ability to analyze work processes and implement changes

Excellent written and verbal communication skills

Strong organizational and project management skills

Proficient with word processing and spreadsheet applications

Preferred Skills

Expert knowledge of Medesis / Paylocity systems / eHealthDeck / Medegy Ticketing System / SQL Server Reporting System (SSRS)

Experience working with clearinghouses; Waystar / Optum / Payer website for claim status

Medical/Surgical claims experience

Florida Medicare / Medicaid Program knowledge

Experience working with Standard EDI Transaction Sets (i.e., 835, 837, 277)

Medicare & Medicaid Overpayment recovery process 

Claims Audit experience

#LI-VISIONCARE

Compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding VSP Vision benefits, please click here. 

Salary Ranges: $73,500.00 - $131,250.00

VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, gender identity, sexual orientation, disability or protected veteran status.  We maintain a drug-free workplace and perform pre-employment substance abuse testing.

Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/Personal Information. 

We have been made aware that fake job opportunities are being offered by individuals posing as VSP Vision and affiliate recruiters. Click here to learn about our application process and what to watch for regarding false job opportunities. 

As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees.  VSP Vision employees will have access to this sensitive personal information and are subject to follow Information Security and Privacy Policies. 

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