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Medical Claims Director

MEDICAL CLAIMS DIRECTOR



Excellent opportunity for senior level medical claims (PPO) manager and leader to join $9B multi-employer health and pension plan trust fund located in Studio City, CA (Los Angeles County), growing service-focused organization, and employer of choice.



Qualified local candidates only, please submit letter of interest including resume and salary requirements.



This key, visible role manages a high volume PPO claims processing/ production/ configuration/ adjustments and auditing department, enthusiastically directs staff of managers, claims processors and administrative staff, and ensures key performance metrics including quality and production standards are met.?



A minimum of 10+ years medical claims (PPO) operations and people management experience in the health insurance industry required, in addition to working knowledge of CPT, ICD9-10 and COB, critical thinking, analytical, and comprehensive problem solving skills. Experience with QNXT claims management software preferred.



?The successful candidate will have outstanding verbal and written communication and presentation skills, strong experience and familiarity with lean/six sigma process improvement,?project management, audit, configuration, and quality improvement reporting.?


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Bachelor's degree required; Master's degree a plus.



Competitive compensation and benefits including free employee health, dental, vision and life insurance ($50/month for family coverage), short and long term disability, pension, 401k, employer funded defined contribution retirement plan, and generous paid time off.



Local candidates only, relocation assistance is not provided.



?Conveniently located in Studio City, CA, the Motion Picture Industry Pension and Health Plans (MPI) are multi-employer trust funds established by collective bargaining agreements between various employers and over 40 Unions and Guilds representing employees in the motion picture industry.



Recognized as an Employer of Choice for its employee-focused work environment, competitive compensation and benefits, MPI is a recipient of the World at Work Seal of Distinction.



?Submissions will be reviewed; Candidates most closely matching the requirements of our open position will be contacted. ??


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?EOE



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