Director of Claims and Enrollment

Job Summary

A company is looking for a Director of Claims and Member Enrollment.

Key Responsibilities

• Oversee and manage the strategic operations of the Claims and Enrollment departments
• Ensure accuracy, efficiency, and compliance of all related processes while driving improvements
• Collaborate with internal and external stakeholders to maintain service excellence and operational efficiency

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, or a related field; Master's degree preferred
• Five years of experience in claims processing and enrollment within a managed care organization or similar setting
• Three years of leadership experience
• Experience with healthcare regulations, including Medicare and Medicaid
• Experience in healthcare management systems and data analytics tools