Director, Claims Administration

Job Summary

This role in Los Angeles, CA is a full-time, onsite position responsible for managing the claims administration process. The position involves leading a team, ensuring compliance with regulations, and utilizing general office software for reporting and data analysis.

Key Responsibilities

• Lead and manage the claims administration process, ensuring accuracy and compliance.
• Develop strategic plans and drive operational improvements.
• Oversee regulatory compliance and audit readiness.
• Collaborate with cross-functional teams to ensure operational integrity.
• Foster a culture of accountability and continuous improvement.

Qualifications

• Bachelor's Degree or equivalent experience required; Master's preferred.
• At least 7 years of healthcare claims experience.
• 5 years of experience leading and managing staff.
• Strong understanding of managed care contracts and payment methodologies.
• Proficiency with general office software and data/reporting tools.