Supervisor, Claims Operations

POSITION SUMMARY

The Supervisor, Claim Operations will help the Management team monitor the daily work within the Claims department.  The Supervisor, Claim Operations, is responsible for the training and development of new hires and existing department staff. The Supervisor, Claim Operations will plan and maintain workflows, procedures and policies that enable and encourage the optimum performance of the team.

ESSENTIAL FUNCTIONS

• Lead employees to meet Allied’s expectations for productivity, quality, and goal accomplishment
• Assist with the development and implementation of detailed workflows to improve the consistency and accuracy of the staff
• Adhere to and apply all applicable privacy and security laws, including HIPAA, HITECH and any regulations promulgated thereto
• Assist other departments on questions related to the payment of claims
• Monitor all reports including the Workflow Manager, Pended claims, Suspended claims, Inventory listings, Audits and Automation to ensure that all workflows are followed
• Attend continuing education classes as required, including HIPAA training
• Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent
• Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed
• Actively engage, coach, counsel and provide timely, and constructive performance feedback
• Other related duties as assigned

EDUCATION

• High school diploma required, Bachelor’s degree or equivalent work experience in the healthcare industry required preferred.

EXPERIENCE AND SKILLS 

• 3 -5 years of experience in healthcare and/or insurance industry preferred.
• 1-3 years prior supervisory experience preferred.
• All applicants must have strong analytical skills and knowledge of computer systems and CPT and ICD-9 coding terminology.   
• Applicants must demonstrate the ability to supervise tasks and contribute to the Team atmosphere and concept.
• Applicants must have a minimum of 5 years of medical claims analysis and adjudication experience (including dental and vision claims analysis).  
• Prior experience in management and training is preferred but not required.

POSITION COMPETENCIES

• Accountability
• Coaching and Feedback
• Collaboration
• Customer Focus
• Decision Making
• Execution Management
• People Leadership

PHYSICAL DEMANDS

• This is a standard desk role that requires extended periods of sitting and computer work

WORK ENVIRONMENT:

• Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.