About Texas Children's HospitalFounded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.
We are searching for a Manager, Claims Administration - someone who works well in a fast-paced managed care setting. In this position, you’ll plan, develop and implement Claims processing functions and related processes for the Claims Administration Department. You’ll have key responsibility for the integrity of the claims payment and adjudication process. Additionally, you’ll be responsible for ensuring that claims are processed accurately and timely for reimbursement to the Health Plan Providers and members, in accordance with contracted fee schedules and covered benefits as specified in the member evidence of coverage.
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Job Duties & Responsibilities
****Medicaid, Medical Commercial Insurance, STAR, STAR + or CHIPS knowledge HIGHLY PREFERRED****
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