Job Description
Our customer is a national insurance administration company who is growing very quickly in the Tampa Bay area. They are experiencing so much growth that they have added a new Claims Supervisor to their team.
The Claims Supervisor is responsible for monitoring the daily activities within the department that processes the billing for patient healthcare services. This Supervisor ensures claims are either approved or denied, based on actual services rendered as well as compared to legislative requirement and plan agreements.
**Please note that this is a onsite position - NO remote work is available.**
Duties and Responsibilities:
• Effectively manage the performance of the Claims Team by providing daily leadership and support
• Provide coaching, feedback, support and direction via positive feedback and reward mechanisms
• Monitor aging of claims to assign work daily.
• Follow and maintain knowledge of Federal and State regulations; implement changes regarding claims and billing requirements
• Develop, revise and monitor KPIs in order to meet department quality, time service and productivity goals
• Provide expertise & claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims
• Conduct regular meetings with staff toward improving performance, quality and documentation.
• Conduct training for new hires and ensure the ramp-up to required metrics is on track.
• Identify and coordinate resources for re-work
• Analyze and identify trends and provide robust reports
Required Experience, Skills and Abilities • Associate's degree in a field related to managing claims in the healthcare field such as business administration, accounting, finance, or a related field or equivalent experience
• 3+ years of experience in a supervisory role in a healthcare claims processing role where HIPPAA and HITECH standards are utilized
• Experience with benefit administration platforms such as Javelina preferred
• Knowledge of Federal and State codes related to fiscal operations of healthcare services
• Knowledge of medical terminology and Diagnosis Codes (ICD-9 & ICD-10)
• Ability to analyze and interpret problems in data collection, billing, and coding. Determine the source of the problem and apply a solution
• Must be able to calculate and re-calculate claims; performing applying formulas using multiplication and percentage
We are an equal opportunity employer and make hiring decisions based on merit. Recruitment, hiring, training, and job assignments are made without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, or any other protected classification. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.
To apply please email your resume to kmajeski@ultimatestaffing.com
Job Snapshot
• Employee Type: Full-Time
• Location: Tampa, FL
• Job Type: Customer Service, Health Care, Insurance
• Experience: Not Specified
• Education: Not Specified
• Date Posted: 9/19/2022
• Contact: Katie Majeski (727) 797-1260
• Pay Range: $60,000.00 - $70,000.00 Annually