Talent.com
Team Lead Configuration (Pricing NV MP)
Team Lead Configuration (Pricing NV MP)CareSource • Dayton, OH, United States
Team Lead Configuration (Pricing NV MP)

Team Lead Configuration (Pricing NV MP)

CareSource • Dayton, OH, United States
[job_card.30_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Job Summary :

The Team Lead, Configuration is responsible for day-to-day activities surrounding the knowledge and insight around development and support of medical benefits, provider reimbursement, letters, and clinical editing.

Essential Functions :

  • Responsible for day-to-day activities surrounding the knowledge and insight around development and support of medical benefits, provider reimbursement, letters, and clinical editing
  • Guide and direct successful completion of daily tasks. Responsible for onboarding, training and development of staff
  • Prioritize all work, requests and activities. Escalate any area of significant resource contention along with recommendation for resolution
  • Track issues and status to ensure proper follow-up, coordination with business area and provide solutions
  • Update project that configuration is involved with and coordinate any needed changes with manager
  • Provide management with ticket dashboards. Identify root cause of issues and appropriate pro-active resolution to reduce tickets in the future
  • Ensure ticket controls, communication and approvals are followed prior to system implementation
  • Maintain and support fee schedules and methodology is consistent with required standards
  • Provide oversight to vendor management tasks conducted by team members. Ensure timely responses and resolution
  • Assist in auditing system configuration to ensure accuracy and internal controls are in place to minimize potential fraud and abuse and any business issues
  • Perform any other job duties as requested

Education and Experience :

  • Associates Degree or equivalent years of relevant work experience is required
  • Minimum of three (3) years of health plan business or systems solutions experience is required
  • Exposure to Facets or equivalent system is preferred
  • Prior supervisory experience is preferred
  • Competencies, Knowledge and Skills :

  • Advanced computer skills and abilities in Facets or similar processing systems
  • Medical terminology
  • Advanced proficiency in Microsoft Suite to include Word, Excel and Access
  • High level of programming and systems development knowledge
  • Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of business partners
  • Demonstrated ability to successfully define a portfolio of initiatives including business requirements gathering, definition / prioritization, project scope definition, project staffing requirements, application configuration, testing approach, training, documentation, reporting strategy, and change management process
  • Knowledge of regulatory reporting and compliance requirements
  • Excellent listening and critical thinking skills
  • Effective problem solving skills with attention to detail
  • Excellent written and verbal communication skills
  • Ability to work independently and within a team environment
  • Strong interpersonal skills and high level of professionalism
  • Ability to develop, prioritize and accomplish goals
  • Proper medical coding knowledge and claims processing skills
  • Licensure and Certification :

  • Certified Professional Coder (CPC) is preferred
  • Working Conditions :

  • General office environment; may be required to sit or stand for extended periods of time
  • Compensation Range :

    $81,400.00 - $130,200.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

    Compensation Type : Salary

    Competencies :

  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business
  • This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

    #LI-GB1

    [job_alerts.create_a_job]

    Team Lead • Dayton, OH, United States

    [internal_linking.related_jobs]
    Network Operations Analyst - 25-03359

    Network Operations Analyst - 25-03359

    LeadStack Inc. • Blue Ash, OH, US
    [job_card.full_time]
    Job Title : Network Operations Analyst.Soft skills! Talk to customers and technicians, secondary – troubleshooting, Some experience in routing and switching, Service Now and similar tools, cha...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    CDL-A Dry Van Team Truck Driver in Brookville, OH

    CDL-A Dry Van Team Truck Driver in Brookville, OH

    AllTruckJobs • Brookville, OH, US
    [job_card.full_time]
    CRST The Transportation Solution Inc.We are looking for CDL A Truck Drivers to run Over the Road.CDL A Teams Average weekly miles 4000+ to the truck. Great benefits, including Medical, Vision and De...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Information Governance Operations Analyst (Hybrid)

    Information Governance Operations Analyst (Hybrid)

    Taft Stettinius & Hollister LLP • Dayton, Ohio, United States
    [job_card.full_time]
    Taft is seeking an Information Governance Operations Analyst to support our Information Governance team in our Chicago, Cincinnati, Cleveland, Columbus, Dayton, Denver, Detroit, Indianapolis or Min...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Side Hustle Project Lead

    Side Hustle Project Lead

    Finance Buzz • Troy, Ohio, US
    [job_card.full_time] +1
    We’re offering a role for someone who wants to lead their own side-income project in their spare time.You’ll explore various proven side hustles, select the ones that fit your lifestyle, and run th...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel - Cath Lab Tech

    Travel - Cath Lab Tech

    Titan Medical (Nebraska) • Laura, OH, United States
    [job_card.full_time]
    WHEN YOU WORK FOR US, WE WORK FOR YOU.With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get unmatched service.From the moment you...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Bus Systems Analyst Lead

    Bus Systems Analyst Lead

    V2Soft • Miamisburg, OH, US
    [job_card.full_time]
    V2Soft is a global leader in IT services and business solutions, delivering innovative and cost-effective technology solutions worldwide since 1998. We have headquarteerd in Bloomfiled Hills, MI and...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    HRIS Analyst

    HRIS Analyst

    CFS • Troy, OH, US
    [job_card.full_time]
    Paycor, open enrollment, benefits administration, and HR operations.HR Director and manage key HRIS and compliance tasks during organizational transition. Handle benefits administration (including C...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Charge Nurse- Team Lead | PT DAY SHIFT

    Charge Nurse- Team Lead | PT DAY SHIFT

    Carespring • Springboro, OH, United States
    [job_card.full_time]
    The Charge Nurse is to assist the Nursing supervisor in the responsibility for the total patient care within the nursing unit, and the management of the unit. RN $35 to $41 depending on experience a...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    RN - Stepdown / PCU / IMC

    RN - Stepdown / PCU / IMC

    Premier Health Miami Valley Hospital • Dayton, OH, United States
    [job_card.full_time]
    Premier Health Miami Valley Hospital.At MedUS Healthcare, our vision is to become a necessary and exemplary partner in the care of our clients, while meeting the employment goals of our healthcare ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Quality Team Lead

    Quality Team Lead

    Vega Americas • Mason, OH, United States
    [job_card.full_time]
    The Quality Team Lead will be responsible for assisting the manager in coaching and monitoring the flow of work through a specific team within the quality department. ESSENTIAL DUTIES AND RESPONSIBI...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Field Collection Specialist

    Field Collection Specialist

    RDSolutions formerly RetailData • West Chester, OH, US
    [job_card.part_time]
    The retail industry continues to see unprecedented dynamics as it pivots to a true omni-channel shopping experience.Informed retailers are succeeding, and RDSolutions is providing them with the con...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Med Tech ( FT, PT & Per Diem)

    Med Tech ( FT, PT & Per Diem)

    Senior Lifestyle • West Chester, OH, United States
    [job_card.full_time]
    Do you have HEART? We are looking for individuals who can embrace our mission to purposely brighten and enrich the lives of those we serve with HEART. Hospitality, Excellence, Appreciation, Respect...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Team Lead Configuration (Pricing NV MP)

    Team Lead Configuration (Pricing NV MP)

    CareSource • Dayton, Ohio, United States
    [job_card.full_time]
    The Team Lead, Configuration is responsible for day-to-day activities surrounding the knowledge and insight around development and support of medical benefits, provider reimbursement, letters, and ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Team Lead

    Senior Team Lead

    CESO Inc • Dayton, Ohio, United States, 45400
    [job_card.full_time]
    Are you seeking purpose, challenge, and talented colleagues? With a diverse portfolio of retail, hospitality, light industrial, healthcare, and worship, CESO has the opportunity for you to expand y...[show_more]
    [last_updated.last_updated_variable_days]
    Desktop Engineer

    Desktop Engineer

    TEKsystems • Evendale, OH, United States
    [job_card.full_time]
    Extensive Windows PC support and configuration experience including Windows 11, with experience in LTSC as a strong preference. Experience with enterprise support including Active Directory Domains ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Electrical Compliance Engineer

    Electrical Compliance Engineer

    Jobot • Troy, OH, US
    [job_card.full_time]
    Electrical Engineers with UL compliance experience take a closer look!.This Jobot Job is hosted by : Lincoln Sprague.Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us y...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Team Lead, Kit Production - 2nd Shift

    Team Lead, Kit Production - 2nd Shift

    Thermo Fisher Scientific • St Bernard, OH, United States
    [job_card.full_time]
    At Thermo Fisher Scientific, you'll discover meaningful work that makes a positive impact on a global scale.Join our colleagues in bringing our Mission to life - enabling our customers to make the ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Lead Transmission Line Engineer

    Lead Transmission Line Engineer

    Leidos Inc • Dayton, OH, United States
    [job_card.full_time]
    Lead Transmission Line Engineer.The successful candidate will serve as a.Lead Engineer and Technical Project Manager.The candidate will apply NESC, ASCE, ACI, NEC, and other applicable standards in...[show_more]
    [last_updated.last_updated_30] • [promoted]