Claims Supervisor Job Ref TE0049 Category: Claims Department CLAIMS Location: 50 Water Street, 7th Floor, New York, NY 10004 Job Type: Regular Employment Type: Full-Time Work Arrangement: Hybrid Salary Range: $60,000.00 - $70,000.00
Position Overview The Claims Supervisor is responsible for the daily oversight of Medicare claims processes, including but not limited to:
In addition, the position assists the Claims Manager with claims-related queue management, such as:
The Claims Supervisor will also provide daily management and oversight of the Claims Operation staff.
Scope of Role & Responsibilities Liaises between claims staff and stakeholders, including:
Participates in claims-related workgroups designed to address claims issues and improve processes.
Prepares routine reports for the manager on:
Identifies system processing issues and assists with the root cause analysis process.
Develops, implements, and maintains claims operation policies, procedures, and workflow.
Assists with the planning, development, and training of claims operations staff.
Provides input related to the development and performance of employees to the Manager.
Manages daily inventory queues and assigns resources to ensure inventory is processed timely and accurately.
Monitors daily inventory and assigned claims queues for production and issue identification.
Generates claims operations dashboard and reports related to inventory and productivity.
Participates in special projects as needed.
Other duties as assigned.
Required Education, Training, & Professional Experience High School Diploma and minimum 7 years of claims operations experience in a healthcare field required or:
Knowledge of claims payment methodologies and policies.
Knowledge of CMS Regulations.
Proficient in reporting applications such as Excel, Access, or SQL preferred.
Professional Competencies