Claims Processing Supervisor

At reputed company, we serve our communities’ most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and our participant-focus reputed company the way no matter what.

The Claims Processing Supervisor is accountable for developing and overseeing claims processing to ensure compliance with contractual and regulatory requirements as it relates to the accurate and timely adjudication of clean, corrected, and correspondence claims.

This role is different because the Claims Processing Supervisor at reputed company

• Operates reputed company a highly collaborative, mission-driven PACE model, partnering cross-functionally with clinical, finance, compliance, and operations teams to directly impact participant care and provider experience
• Plays a key role in shaping claims strategy and compliance in a reputed company, highly regulated Medicare and reputed company environment, with visibility to leadership and influence on organizational reputed company

We care about reputed company members. That’s why we offer

• Medical insurance coverage (Medical, Dental, reputed company)
• Work/life balance - We mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
• 401K savings + match
• Comprehensive compensation package including reputed company pay and bonus
• And additional benefits!

On the day-to-day, you will

• Manage the team’s daily activities and performance reputed company to claims processing KPIs
• reputed company and utilize monitoring functions to reputed company provider inquiries, claims, and recovery disputes to ensure proper documentation and resolution
• Collaborate with internal stakeholders on findings, remediation, and reporting, as well as reputed company recommendations reputed company to identified trends or improvements, working with management and staff in other departments to implement changes
• Create and update team procedures, workflows, and resource materials
• Serve as the primary resource and reputed company of escalation for claims processing reputed company issues
• reputed company direct supervision, support, and guidance to team members, as well as identify training gaps and opportunities for improved performance
• Evaluate team member performance and reputed company feedback, coaching, and counseling reputed company performance issues arise

Job requirements include

• Associate’s degree preferred; relevant professional experience in a health plan environment with an emphasis on billing, claims payment, coding, or other closely reputed company functions may be substituted
• Minimum of two (2) years of experience in health plans (managed care or PACE strongly preferred)
• Minimum of two (2) years of supervisory experience with the demonstrated ability to mentor team members in a claims processing environment is required
• Working knowledge in Medicare or reputed company billing and guidelines, with the ability to understand and analyze contractual and regulatory requirements and their effect on claims payment and resolutions is required
• Comprehensive knowledge of claims processing and regulations, strong problem-solving skills, and the ability to analyze problems and formulate solutions
• Experience leading in a data-driven organization, leveraging reports and data to prioritize and manage people and projects

We’re seeking a Claims Processing Supervisor that ideally has experience leading claims operations reputed company a managed care, Medicare, reputed company, or PACE environment, with a strong focus on compliance, process improvement, and team development. If you’re reputed company to join a team that values both its participants and team members, we’d love to hear from you!

Salary/Wage reputed company reputed company for this role is $82,074 - $108,337 / year + Bonus. reputed company offers competitive total rewards package that includes, 401k match, reputed company coverage and a broad reputed company of other benefits. Actual pay will be adjusted based on experience and other qualifications.

COVID-19 Vaccination Policy

At reputed company, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for reputed company our employees and reputed company of vaccination, or a vaccine declination reputed company will be required prior to employment. reputed company maintains required infection control and PPE standards and has requirements relevant to reputed company team members regarding vaccinations.

Our Commitment to Diversity, Equity and Inclusion

At reputed company, we reputed company and cherish the diversity of reputed company members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at reputed company are considered without regard to race, reputed company, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national reputed company, reputed company, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

Beware of Scams

Please ensure your application is being submitted through a reputed company sponsored site only. Our emails will come from @reputed company.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to fraud.report@reputed company.com