Children’s Physicians Medical Group (CPMG) is an Independent Physicians Association (IPA) comprised of Pediatricians and Pediatric Specialists associated with Rady Children’s Hospital-San Diego. CPMG contracts with Health Plans and third parties to support the Children’s Healthcare Integrated Delivery System in a managed care environment. We provide a central contracting approach for our member physicians in San Diego and southern Riverside counties and support a network of over 400 providers for 70,000 patients. We offer a competitive compensation and benefits package.

Current Openings:

Posted on Jan 6, 2014

Claims Manager

Job Description:

CPMG has an exciting opportunity for a dedicated and caring professional to join our team as a Claims Manager.  Reporting to the Claims Director, the ideal candidate will manage the day to day operations of the claims department to ensure that all applicable claims are submitted accurately and timely to the Health Plans. The Claims Manager will be responsible for staff management including candidate selection, performance management, work-load evaluation and assignment, as well as teambuilding and recognition.  The Claims Manager also regularly reviews outgoing communications including EOBs, COBs and ensures production and guidelines for claims processing are met. The successful Claims manager will build and lead a strong team and champion service excellence.

The ideal candidate will possess:

 *   Bachelor’s degree or equivalent work experience.

 *   Minimum of 5 years of progressive Supervisory experience

 *   Minimum of 10 years of Managed Care experience required.

 *   Highly proficient in claims processing and knowledgeable in all applicable laws and regulations.

 *   Strong computer skills with knowledge of Excel, Word, PowerPoint, Outlook, and Access.

 *   Excellent verbal and written communication skills.

 *   Strong analytical and problem solving skills.

 *   Demonstrated experience with EZCap is highly desirable.

For consideration please email resume and cover letter including salary requirements to or fax to (858) 576-1796. 

Children’s Physician Medical Group offers the full scope of benefits, a great compensation package and opportunities for professional growth. EOE

CPMG is an equal opportunity employer.