Become a part of our caring community and help us put health first
 

Be a part of the Service Operations world by leading a team of service professionals in a fast-paced and metric-driven environment.

The Supervisor, Claims Processing will directly lead and guide 14 associates in delivering service and Operational Excellence through the consistent application of Human Capital strategies which focus on continuous improvement in the areas of contributions, competencies, and performance.

The Supervisor, Claims Processing

• Commitment to preserving confidentiality

• Ensure appropriate staffing levels are achieved to ensure resources are managed effectively

• Provide guidance and leadership to associates and serve as a mentor for their day-to-day activities

• Identify reasons for variation in individual performance and take appropriate actions that will result in improved production and quality performance

• Analyze data to guarantee key performance measures are met, while aiding in the removal of barriers to success of organizational goals

• Hands on leadership

• Ensure timely trainings on errors identified from internal or external customers with hands on experience to support team success

• Maintain proactive communication and collaboration with other departments to ensure efficient, accurate and timely responses to internal customer needs

• Review projects and tasks submitted and identify gaps and opportunities

• Conduct meetings with external departments to present findings with recommendations

Use your skills to make an impact
 

Required Qualifications

• 2 or more years of supervisory and/or leadership experience leading a minimum of 10 associates in a work-at-home environment

• 2 or more years of Medical Claims Processing, Medical Coding/Billing and/or Provider Customer Service in a service operational setting

• Intermediate proficiency in Microsoft Office Word and Excel

• Experience with coordinating and leading projects/initiatives

Preferred Qualifications

• Bachelor's Degree

• Lean, Six sigma experience and/or certifications

• Strong process and project management skills

Hours:  Flex Start Time: 6:00 a.m. to 9:00 a.m. EST Monday – Friday with ability to support business as needed for overtime. Nights, Weekends, Holiday based on business needs.

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

• Satellite, cellular and microwave connection can be used only if approved by leadership

• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

Alert:  Humana values personal identity protection.  Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file.  When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

#LI-BB1

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$57,700 - $79,500 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties.

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.