Manager, Claims Processing - Covered California

The Manager, Claims Processing - Covered California is responsible for oversight and direction of claims and auditing activities of the Covered California (CCA) vendor and personnel. This position requires excellent communication, collaboration and leadership skills and the ability to provide detailed instructions to vendor and staff while monitoring inventory and compliance metrics within the department to ensure that our provider and member needs are met in a timely manner.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

• CalPERS retirement
• 457(b) option with a contribution match
• Generous paid time off- vacation, holidays, sick
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Paid life insurance for employees with additional options
• Short-term, and long-term disability options
• Pet care insurance
• Flexible Spending Account – Health Care/Childcare
• Wellness programs that promote a healthy work-life balance
• Career advancement opportunities and professional development
• Competitive salary with annual merit increase
• Team bonus opportunities

Education & Experience

• Five (5) years of Claims Processing experience, at least (3) three of which was in a management capacity
• Three (3) years of experience in an HMO or managed care environment.
• Experienced in benefit and interpretation, regulatory payment appeals, and claim adjudication
• The Manager must have past Covered California or Commercial Claims Processing experience
• Bachelor’s degree from an accredited institution required, degree preferably in Business Administration, Accounting or Healthcare from an accredited institution required

• Excellent communication, collaboration, and leadership skills.

Start your journey towards a thriving future with IEHP and apply TODAY!