[Hiring] Supervisor, Claims Operations @Allied Benefit Systems

Role Description

The Supervisor, Claim Operations will help the Management team monitor the daily work within the Claims department. The Supervisor, Claim Operations, is responsible for the training and development of new hires and existing department staff. The Supervisor, Claim Operations will plan and maintain workflows, procedures and policies that enable and encourage the optimum performance of the team.

Essential Functions

• Lead employees to meet Allied’s expectations for productivity, quality, and goal accomplishment.
• Assist with the development and implementation of detailed workflows to improve the consistency and accuracy of the staff.
• Adhere to and apply all applicable privacy and security laws, including HIPAA, HITECH and any regulations promulgated thereto.
• Assist other departments on questions related to the payment of claims.
• Monitor all reports including the Workflow Manager, Pended claims, Suspended claims, Inventory listings, Audits and Automation to ensure that all workflows are followed.
• Attend continuing education classes as required, including HIPAA training.
• Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent.
• Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed.
• Actively engage, coach, counsel and provide timely, and constructive performance feedback.
• Other related duties as assigned.

Qualifications

• High school diploma required, Bachelor’s degree or equivalent work experience in the healthcare industry preferred.
• 3 - 5 years of experience in healthcare and/or insurance industry preferred.
• 1 - 3 years prior supervisory experience preferred.
• Strong analytical skills and knowledge of computer systems and CPT and ICD-9 coding terminology.
• Demonstrated ability to supervise tasks and contribute to the Team atmosphere and concept.
• Minimum of 5 years of medical claims analysis and adjudication experience (including dental and vision claims analysis).
• Prior experience in management and training is preferred but not required.

Position Competencies

• Accountability
• Coaching and Feedback
• Collaboration
• Customer Focus
• Decision Making
• Execution Management
• People Leadership

Physical Demands

This is a standard desk role that requires extended periods of sitting and computer work.

Work Environment

Remote

Benefits

• Medical, Dental, Vision, Life and Disability Insurance
• Generous Paid Time Off
• Tuition Reimbursement
• EAP
• Technology Stipend