Intake Care Supervisor

JOB PURPOSE

The Intake Care Supervisor directs the activities of staffs who are adjudicating and finalizing Pre-authorizations. As a subject matter expert to take an initiative in assisting team requirements pertaining to the operational software and tasks related to the policy coverage terms.

RESPONSIBILITIES AND DUTIES

• Perform job supervisory duties to assure proper training, instructions, and development of staff.
• Control cost by all permissible, equitable, fair means.
• Closely coordinate with the Reporting Manager on staff performance reviews and leave scheduling;
• Delegate and oversee activities performed by claims examiners.
• Daily monitoring of pipelines and queues.
• Identify training requirements within the team and perform training sessions.
• Responsible in maintaining the assigned TAT of the respective teams and ensuring the optimal utilization of resources.
• Address any internal grievances and escalate to reporting manager if required.
• Responsible for reporting of identified Fraud, Waste and Abuse trends and escalating to concerned parties
• Escalate any identified software issues to the reporting manager and IT POC as required.
• Identify gaps in performance and offer coaching to officers as needed.
• Proper communication and identifying training requirements within the team.
• Strictly applies reporting manager’s directions.
• Carry out any other related functions as directed by the company management.

KNOWLEDGE, SKILLS AND EXPERIENCE

• University degree in any discipline of medical/Para-medical science from a reputable university.
• Strong industry knowledge (healthcare / insurance).
• Should be a team-player with an aptitude for customer service.
• Excellent oral and written communication skills.
• Must be computer literate.
• Excellent command of the English language.
• Ability to work under pressure.
• 5+ years’ experience in the healthcare industry / hospitals.
• Business acumen, persuasive skills and ability to lead a team.  
• Strong decision-making ability; Good understanding of internal processes and software systems.

COMMUNICATIONS AND WORKING RELATIONSHIPS

Ensure seamless communication between all departments for the smooth operations and to   achieve the organizational objective. Establish strong internal & external communication.

About The Cigna Group