General Transaction Processing

•Oversees staff whose primary function is to support the clinical, claim managers and client teams with the delivery of administrative duties and in a supportive role.

•Accountable for the overall skill/competency and development of his/her direct reports.

•Accountable for overall service level performance of associates according to established policies and business rules set by the client.

•Assists the Manager in overall management of day to day operations by effective monitoring and management of team performance.

•May serve as departmental liaison to other areas of the Claims Management unit

•Responsible for maintaining contractual and regulatory compliance by knowing, understanding, correctly interpreting, and accurately applying requirements, regulations and standards.

•Reports suspected or confirmed issues on the same day of discovery to the manager and/or the Compliance Department

•Responsible for ensuring Associate understanding of contractual and regulatory requirements and reporting immediately all suspected or confirmed issues or concerns to a manager and/or the Compliance Department.

•Responsible for ensuring that where applicable, all clinically licensed associates maintain active, documented licensure while working in production

•Removes clinical associates from production when active clinical licensure is not documented in the Personnel Record

•Provides leadership, mentoring, and supervision of staff