Director of Eligibility

NaphCare is hiring an experienced Director of Eligibility to join our team at the Corporate Headquarters in Birmingham, AL.

NaphCare is a family owned, medical technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 35 years. Come join our team of over 6000 employees and growing! NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do.

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare as you use our cutting-edge resources, including our award-winning electronic operating system

NaphCare Benefits for Full-Time Employees Include:

Prescriptions free of charge through our health plan
• Health, dental & vision insurance that starts day one!
• Lowest Cost Benefitsfor Employee and their Family!
• Employment Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• On-site education
• Free Continuing Education!
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays

NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up-to-date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing.

With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry. If you want a career that will make a difference, choose the company that is different.

We support your growth and internal promotion. Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.

Responsibilities for the Director of Claims Management:

• Understanding and applying federal, state and local laws & policies related to patient eligibility.
• Establish patient eligibility and enrollment guidelines based on contractual requirements with clients.
• Develop and maintain system designed to determine financial responsibility of patient medical claims.
• Provide direction to Eligibility Team.
• Analyze reports and review internal audits to ensure benchmarks are met.
• Manage timecards, coordinate time off requests, and coverage.
• Appropriately communicate information both verbally and in writing to clients, team members, and executive management.
• Communicate with other departments as needed to ensure claims are processed accurately and timely.
• Train all new employees and coordinate ongoing training for current team members to ensure all NaphCare processes and job functions are followed.
• Delegate tasks to the team appropriately and provide support to the team members.
• Exhibit a high comfort level in working with large volumes of data.
• Demonstrate a strong attention to detail and a commitment to customer service throughout the eligibility process.
• Additional duties and specific projects as assigned.
• Reports to Vice President, Claims Administration.

Qualification for the Director of Claims Management:

• Bachelor's degree required.
• 5+ years Sr. Manager Business Operations.
• 5+ years supervisory/managerial experience in Revenue Cycle.
• Knowledge of Medicaid, Medicare and ACA programs.
• Strong leadership and training skills.
• Strong Human Resource skills.
• Strong follow-up skills.
• Excellence in Microsoft Office Suite and strong written and verbal communication skills required.

We know you may have questions before applying. To speak to a recruiter directly, email your questions and/or resume to hiring@naphcare.com with the position and location you're interested in.

Equal Opportunity Employer: disability/veteran

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