Insurance Manager – Clinical Background

Insurance Manager – Clinical Background Required

DOC MEDICAL CENTER

Full-Time

Role and Responsibilities:

• Prospective Insurance companies identified, agreements reviewed, the selection made, and contracts awarded.
• Insurance policies implemented after the agreement is signed.
• Follow up and negotiations with Insurance Companies where needed to ensure approval of problematic cases.
• Exhausted benefits identified in close liaison with re‑submissions team to ensure maximum recovery from Insurance companies.
• Insurance protocols complied with at all times.
• Disallowance reconciliation and mutual settlement coordinated with Insurance Companies.
• Insurance disallowance write‑offs coordinated with Accounts Receivables department after proper reconciliation.
• Disallowance reasons evaluated, improvement areas identified, and changes implemented.
• Submission of Insurance department statistics on a monthly basis.
• Work distribution within insurance team/coaching of insurance team members.
• Management of regional operational insurance programs (property‑business interruption, third‑party liability) including service agreements with brokers.
• Regularly review outstanding claims and liaise with the Management/Finance Department to ensure the adequacy of claim reserves.
• Prepare all statistics required by Management including rejections, insurance company breakdown of revenue & claims.
• Achieve monthly team targets in terms of claims processed.
• Communicate with other department managers pertaining to issues related to claims processing and vice versa.
• Oversees operational systems, processes, and infrastructure while looking for opportunities of improvement or revision.
• Anticipates and tracks insurance and tactical risks and providing strategic solutions.
• Manages day‑to‑day business of the Insurance department while balancing the responsibilities of various business lines such as business analysis.
• Works with other teams to help set and meet daily and quarterly goals.
• Works closely with GM on other special planning and departmental projects.
• Oversees and reports weekly, monthly, quarterly, and annual metrics.
• Identifies trends and assess opportunities to improve processes and execution.
• Completes reasonability testing and information validation prior to circulating findings and recommendations to key stakeholders.
• Collaborates with other back‑office team members to ensure seamless business execution, reinforce positive morale, and uphold company values.
• Collaborates with transition and onboarding teams as needed.
• Raises and tracks issues and conflicts, removes barriers, resolves issues of medium complexity involving stakeholders and escalates to appropriate level when required.
• Assesses a variety of situations and provides clarity to team and stakeholders.
• Establishes and maintains credible, professional relationships with clients, internal business lines, and external vendors.
• Solicits and responds to feedback while gaining commitment and support.
• Supports back‑office and firm‑wide training programs, reinforcing technology and operations infrastructure between departments to ensure consistency and quality standards are met.
• Stays up to date on industry regulations, trends, and technology.
• Works closely with management team to ensure all operational, administrative, and compliance functions within the firm are being properly executed in accordance with regulatory‑based best practices.
• Any other task as assigned by management on a time‑to‑time basis as per the organization’s needs.

Job Type: Full‑Time