Claims Processing Supervisor supervises the administration of health insurance claims, payment processing, billing research, and responding to inquiries. Ensures the accurate and timely disposition of claims and resolves matters according to coverage amounts and company procedures. Being a Claims Processing Supervisor provides guidance to staff on more complex or high-value claims. Reviews and resolves escalated issues. Additionally, Claims Processing Supervisor requires a high school diploma. Typically reports to a manager. The Claims Processing Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. To be a Claims Processing Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision. (Copyright 2024 Salary.com)
Job Ref: 104168
Category: Claims
Department: CLAIMS
Location: 50 Water Street, 7th Floor,
New York,
NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $60,000.00
Salary Range: $60,000.00 - $70,000.00
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
The Claims Supervisor is responsible for the daily oversight of claims processes including but not limited to the inquiry and resolution process, adjudication process, user acceptance testing and quality assurance, training, and reporting. In addition, the position assists the claims manager with claims related queue management (i.e. claims, inquiries, refunds, adjudications) to ensure that inventory is processed accurately and in a timely manner. The Claims Supervisor will also provide daily management and oversite of the claims operation staff.
Professional Competencies
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