Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.
By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.
At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.
If this sounds like you, read on!
The Claims Research and Resolution Manager will have direct oversight of the Research and Resolution team, assisting the Research and Resolution Director in the daily and/or monthly operational and administrative duties, to ensure the efficient and effective performance of the staff. This position is intended to be a supportive role to the staff; therefore, the Manager serves as a liaison for the staff. This position will be responsible for understanding all Research and Resolution department tasks in addition to handling other administrative duties. The Claims Research and Resolution Manager will work collaboratively with the other Research and Resolution Manager and the Provider Resolutions Manager in developing policy, procedures, and creating Sop’s for the Research and Resolution department. The Claims Research and Resolution Manager will also be responsible for training new employees as well as training the team for any new or updated claims processing platforms. The Claims Research and Resolution Manager will act as a liaison for internal team and external providers to ensure claims issues are tracked, identified, and resolved. The Claims Research and Resolution Manager is responsible for Reconsiderations and claims escalations for all lines of business.
All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE
Our mission is to inspire healthy living within the communities we serve!