Claims Manager. The Contractor shall employ a Claims Manager dedicated full- time to the Contractor’s Indiana Medicaid product lines and responsible for ensuring prompt and accurate provider claims processing in accordance with the terms of the Contract. This individual shall work in collaboration with the IS Coordinator to ensure the timely and accurate submission of encounter data as delineated in Section 8.5.
Claims Manager. The Contractor shall employ a Claims Manager responsible for ensuring prompt and accurate provider claims processing in accordance with the terms of the Contract. This individual shall work in collaboration with the CIO or IT Director to ensure the timely and accurate submission of encounter data as delineated in Section 8.6. The Claims Manager (or Utilization Management Manager, as applicable) shall work with the Special Investigation Unit (SIU) Manager to assure that service billing and utilization issues are documented and reported to the SIU, and matters requiring SIU review or investigation shall be timely submitted within five (5) business days to enable recovery of overpayments or other appropriate action.
Claims Manager. The Contractor shall employ a Claims Manager dedicated full- time to the Contractor’s Indiana Medicaid product lines and responsible for ensuring prompt and accurate provider claims processing in accordance with the terms of the Contract. This individual shall work in collaboration with the CIO or IT Director to ensure the timely and accurate submission of encounter data as delineated in Section 8.6. The Claims Manager (or Utilization Management Manager, as applicable) shall work with the Special Investigation Unit (SIU) Manager to assure that service billing and utilization issues are documented and reported to the SIU, and matters requiring SIU review or investigation shall be timely submitted within (5) business days to enable recovery of overpayment or other appropriate action.
Claims Manager. The Contractor shall employ a Claims Manager responsible for ensuring prompt and accurate provider claims processing in accordance with the terms of the Contract. This individual shall work in collaboration with the CIO or IT Director to ensure the timely and accurate submission of encounter data as delineated in Section 8.6. The Claims Manager (or Utilization Management Manager, as applicable) shall work with the Special Investigation Unit (SIU) Manager to assure that service billing and utilization issues are documented and reported to the SIU, and matters requiring SIU review or investigation shall be timely submitted within five (5) business days to enable recovery of overpayments or other appropriate action. ▪ Care Management Manager - The Contractor must employ a full-time Care Management Manager dedicated to the Hoosier Care Connect program. This Manager must oversee the disease management, care management, complex case management and Right Choices Program (RCP) functions as outlined in Section 5.0. The Care Management Manager must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to a variety of populations. This individual will work directly under the Contractor’s Medical Director to develop, expand and maintain the care management program. The individual will be responsible for overseeing care management teams, care plan development and care plan implementation. The Care Management Manager will be responsible for directing the activities of the care managers. These responsibilities extend to physical and behavioral health care services. This individual will work with the Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Management Manager will provide input, as requested by the State, at State-level meetings. ▪ Indiana Department of Child Services (DCS) Liaison - The Contractor must employ a full-time Liaison to Indiana DCS, dedicated to overseeing the Hoosier Care Connect wards and xxxxxx children population. The Liaison shall be responsible for coordinating with the two (2) designated Indiana DCS staff to promptly resolve any issues identified by the Contractor, Indiana DCS, or the State that arise related to the program or to the individual healthcare of a member. The Liaison shall also be responsible for aiding in the transition of the Hoosier Care Connect wards and xxxxxx chil...
Claims Manager. The individual designated by the Employer who is charged with the responsibility of administering the procedures herein.
Claims Manager. The individual designated by the Village who is charged with the responsibility o f administering the procedures herein.
Claims Manager. The individual(s) designated by the County who is/are charged with the responsibility for administering the procedures herein. The Union shall be advised, in writing, by the County of the individual(s) designated, and changes as they occur.
Claims Manager. The Claims Manager for the purpose of the Claims Conditions is DMS, XX Xxx 0000, XX0 0XX. To notify a loss under Claims Condition 2, email: xxxxxxxxx.xxxxxxx@xxxxxx-xxxxx.xxx All other communications with the Claims Manager shall be sent by email to: xxxx.xxxxxxx@xxxxxx-xxxxx.xxx or by post or by hand to DMS at the above address. The Claims Manager will also be available on: 0344 8562 364.
Claims Manager. The CCN shall have a designated person qualified by training and experience to oversee claims data submittal and processing and to ensure the accuracy, timeliness and completeness of processing payment and reporting.
Claims Manager. Individual shall be responsible for and qualified by training and experience to oversee claims processing and to ensure the accuracy, timeliness, and completeness of processing payment and reporting.
