Program Liaison/Claims Manager

<strong>At CNSI, we strive to be the market leader and most trusted partner for innovative and transformative technology-enabled solutions that improve health outcomes and reduce costs. We&rsquo;re passionate about helping our clients improve the health and well-being of individuals and families. We succeed when our clients succeed.</strong>

Tallahassee, FL

CNSI

<strong>CNSI delivers a broad range of health information technology enterprise solutions and customizable products to a diverse base of state and federal agencies. We align, build, and manage innovative, high-quality, cost-effective solutions that help customers achieve their mission, enhance business performance, reduce costs, and improve health for over 51 million Americans.</strong> https://www.cns-inc.com/

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Full-Time

Overview: CNSI is currently looking for Program Liaison/Claims Manager to join our Government Health &amp; Human Services team and Florida state project in Tallahassee. As the Program Liaison/Claims Manager, you will be responsible for managing, directing, and monitoring the personnel and the activities supporting the operation and maintenance of Workers Compensation Medical Bill Process (WCMBP) Programs including, but not limited to, bill intake, authorization, processing, and communication with the client.&nbsp;<strong>*<em>Must be willing and ready to work from the Tallahassee site office when it reopens.</em></strong>
Responsibilities: <ul> <li>Research medical bill/claims issues to identify root causes and determine corrective actions to resolve issues, communicate findings, and document findings for future use.</li> <li>Review bills for necessity, limitations, and exclusions based on bill policies and procedures.</li> <li>Assist internal associates with bill-related questions and issues.</li> <li>Identify reoccurring problems and provide feedback to management to affect change.</li> <li>Maintain current knowledge of Workers Compensation bill processing policies.</li> <li>Responsible for the delivery of the key performance indicators, including quality, productivity, and compliance parameters.</li> <li>Identify continuous process improvement opportunities and work closely with the government to implement action plans.</li> <li>Deliver regular and timely coaching and feedback to the team members to enhance performance and for continuous development/succession</li> <li>Act as the day-to-day operations client contact in order to resolve complex issues.</li> </ul>
Requirements: <ul> <li>You have a familiarity with medical bill forms, ICD-9/10CM coding, CPT coding, bill forms, and other medical coding schemes (certificate desired).</li> <li>You are knowledgeable in medical terminology.</li> <li>You possess an unwavering commitment to customer service and operational excellence.</li> <li>You have either a BS/BA degree, with recent experience of at least:</li> <ul> <li>Five (5) years in project/program management;</li> <li>Enterprise account level management, or other similar customer-facing role consulting on or delivering technical products or services related to medical bill/claims processing or similar environment;</li> <li>Three (3) years of that experience in a project/program management leadership role, consulting on or delivering technical products or services related to medical bill/claims processing or similar environment (may overlap with other experience).</li> </ul> <li>In lieu of a BS/BA you must have the following experience:</li> <ul> <li>High School or GED equivalent diploma;</li> <li>A minimum of eight (8) years in project/program management, enterprise account level management, or other similar customer-facing role consulting on or delivering technical products or services related to medical bill processing or similar environment;</li> <li>At least five (5) years of that experience must be in a project/program management leadership role, consulting on or delivering technical products or services related to medical bill processing or similar environment (may overlap with other experience.</li> </ul> </ul> <br /> <p><strong><em>About Us:</em></strong></p> <p>At CNSI, we strive to be the market leader and most trusted partner for innovative and transformative technology-enabled solutions that improve health outcomes and reduce costs. We&rsquo;re passionate about helping our clients improve the health and well-being of individuals and families. We succeed when our clients succeed.</p> <p>Innovation and commitment to our mission are core to our DNA. And through our shared values, we foster an environment of inclusion, empowerment, accountability, and fun! You will be offered a competitive compensation and benefits package. &nbsp;</p> <p>CNSI is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, marital status, genetic status, family responsibilities, protected veteran status, or any other status protected by applicable Federal, State, or Local Law. We are proud of our diversity and encourage all qualified applicants to apply.&nbsp;</p>