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SalarySupervisor, Claims Operations
POSITION SUMMARY
Assist the Management Team with the monitoring and management of the daily work and other functions within the Department as well as training for new and existing department staff. Planning and maintaining 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 but not limited to HIPAA, HITECH and any regulations promulgated thereto.
- Assist other departments on questions related to the payment of claims.
- Monitor all reports including but not limited to 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 but not limited to 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.
- Perform other duties and responsibilities, as assigned.
EDUCATION
- High School Diploma, College and Advanced Degrees Preferred.
- Continuing education in all areas affecting group health and welfare plans is required.
EXPERIENCE & SKILLS
- Must have a minimum of 5 years of medical claims analysis and adjudication experience (including dental and vision claims analysis) required.
- Must possess demonstrated leadership potential required
- Must have strong analytical skills and knowledge of computer systems and CPT and ICD-9 coding terminology.
- Must demonstrate the ability to supervise tasks and contribute to the Team atmosphere and concept.
COMPETENCIES
- Accountability
- Communication
- Action Oriented
- Timely Decision Making
- Building Relationships/Shaping Culture
- Customer Focus
Physical Demands
- The employee is regularly required to sit, talk, or hear; frequently required to use repetitive hand motion.
WORK ENVIRONMENT
- Remote
