11 часов назад
Supervisor, Claims (Health Insurance)
56 200 - 101 000$
Мэтч & Сопровод
Для мэтча с этой вакансией нужен Plus
Описание вакансии
Текст:
TL;DR
Supervisor, Claims (Health Insurance): Overseeing daily medical claims operations and supporting staff in resolving complex claims with an accent on regulatory compliance, accuracy, timely processing, and operational cost control. Focus on improving claims workflows, analyzing quality trends and root causes, and coordinating with internal customers, vendors, and other stakeholders.
Location: Remote-MO; must be authorized to work in the United States without current or future employment-based visa sponsorship.
Salary: $56,200–$101,000 per year.
Company
connects people with healthcare services and works to improve access and outcomes for individuals, families, and communities.
What you will do
- Oversee daily claims operations and ensure inventory is processed accurately, on time, and in compliance with internal and regulatory requirements.
- Provide technical and leadership support for complex claims, including reviewing, investigating, adjusting, resolving, and escalating pending claims.
- Prioritize workloads through reporting and load balancing while managing operational overtime costs.
- Identify process improvements and resolve operational gaps using financial, regulatory, cost-benefit, and stakeholder-experience considerations.
- Monitor claims quality reviews, document findings, identify trends, and perform systemic root-cause analysis.
- Prepare operational reports and analysis, maintain documentation, and coordinate with internal departments, vendors, and other stakeholders.
Requirements
- Associate degree in a related field or equivalent experience.
- At least 2 years of experience in the health insurance industry, claims processing, a physician’s office, or other office services.
- Previous supervisory or lead experience with defined outcomes.
- U.S. work authorization is required; employment-based visa sponsorship is not available now or in the future.
Nice to have
- Experience with Medicaid, Marketplace, and/or Medicare.
Culture & Benefits
- Health insurance, 401(k), and stock purchase plans.
- Tuition reimbursement, paid time off, and holidays.
- Flexible work approaches, including remote, hybrid, field, and office schedules.
- Equal opportunity workplace committed to diversity and inclusion.
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