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Memphis, TN
(Click company name to view employer profile and all available positions.)
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| Career Field |
Claims, Operations
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| Insurance Discipline |
All
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| Relocation Assistance |
Not Available
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| Job Duration |
Full Time |
| Salary Offered |
Open
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Description |
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice® designation. Come be a part of our team and 'Claim Your Future.' PRIMARY PURPOSE: To ensure Electronic Data Interchange (EDI) compliance, including EDI implementation, trouble shooting, training and coordination of system issues with Information Technology (IT). ESSENTIAL FUNCTIONS and RESPONSIBILITIES: - Develops and revises EDI service expectations; develops state-specific strategies to EDI requirements; ensures EDI compliance throughout the Company; identifies EDI issues and trends; and develops action plans to address EDI issues.
- Researches and communicates EDI requirements and strategies; works with IT and Casualty Operations on EDI strategies and compliance.
- Manages EDI implementations.
- Develops and assists in delivery of EDI training.
- Serves as contact on issues relative to EDI issues for state agencies; serves as liaison for carrier partners on EDI issues and penalties within jurisdiction; and develops/revises penalty avoidance strategy, tracking and reporting.
- Completes/updates trading partner agreements as needed.
- Assists with medical e-billing.
- Maintains an EDI quality assurance program to support the Total Performance Management initiative and the consistent delivery of quality claims service.
- Travels as needed.
SUPERVISORY RESPONSIBILITIES: - Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
- Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
- Provides support, guidance, leadership and motivation to promote maximum performance.
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| | Qualifications | QUALIFICATIONS: Education & Licensing:
Baccalaureate degree from an accredited college or university preferred. Experience:
Seven (7) years experience in project management required. Experience managing national initiatives strongly preferred. Training experience preferred. Skills & Knowledge: - Knowledge of International Association of Industrial Accidents Boards and Commissions (IAIABC) EDI requirements
- Thorough knowledge of EDI processes and compliance requirements
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Leadership/management/motivational skills
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Excellent negotiation skills
- Ability to manage multiple projects in fast paced environment
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT: When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking Sedgwick CMS is an Equal Opportunity Employer and a Drug-Free Workplace |
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