[Hiring] Claims Supervisor @Highmark Health

Role Description

This job supervises and coordinates the day-to-day activities of the various claims processing or claims adjustment units responding to internal inquiries or inquiries received by members, providers, or account representatives across all markets.

Essential Responsibilities

• Communicate effectively.
• Effectively supervise all assigned personnel.
• Coordinate any claim backlog distribution for regular and overtime work both interdepartmentally and companywide.
• Monitor and manage daily inventories to ensure adequate staffing and resources are available.
• Subject matter expert for benefit plan and claims processing issues, implementation of new groups and products, and transition meetings.
• Research quality issues and respond to error assessments.
• Ensure all business processes are routinely monitored. Recommend and design, if necessary, process improvements designed to improve accuracy, timeliness of process and/or eliminate manual effort.
• Other duties as assigned or requested.

This position supervises employees mostly in the State of New York: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, and Wyoming counties.

Qualifications

• High School Diploma or GED
• 2 years experience in a claims environment
• 1 year experience leading or supervising others

Preferred Qualifications

• Bachelor’s degree

Skills

• Knowledge of multiple processing systems and workflows
• Knowledge of claims processing methodologies
• Ability to interpret all government regulations
• Knowledge of Highmark products

Travel Requirements

• 0% - 25%

Physical, Mental Demands and Working Conditions

• Position Type: Remote Office-based
• Teaches / trains others regularly: Occasionally
• Travel regularly from the office to various work sites or from site-to-site: Rarely
• Works primarily out-of-the office selling products/services (sales employees): Never
• Physical work site required: Yes
• Lifting: up to 10 pounds: Constantly
• Lifting: 10 to 25 pounds: Occasionally
• Lifting: 25 to 50 pounds: Rarely

Compliance Requirement

This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. Employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. All employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) and the company’s Code of Business Conduct.

Pay Range

• Pay Range Minimum: $58,100.00
• Pay Range Maximum: $90,000.00

Equal Opportunity Statement

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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