Claims Examiner Supervisor

Conifer Health Solutions • Frisco, TX

3d • Onsite

About The Position

This role involves supervising a team of claims personnel and managing claims inventory for multiple companies in accordance with state and federal guidelines. The supervisor will utilize inventory management systems and reports, collaborate with other departments to resolve issues, and review/update policies and procedures. Key responsibilities include managing work behaviors, coaching, counseling, rewarding staff, and conducting monthly/annual performance reviews.

Requirements

• General office equipment experience
• Excellent understanding of health and managed care concepts and their application in the adjudication of claims.
• Strong working knowledge of ICD.9.CM, CPT, HCPCS, RBRVS coding schemes and medical terminology.
• High School Diploma or Equivalent
• Must be able to work in sitting position, use computer and answer telephone
• Ability to travel (minimal)
• Light physical effort (lift up to 10lbs).
• Regularly needs to be able to bend, stoop and reach to file.

Nice To Haves

• 5-6 years Supervisory/Management experience preferred.
• 2-3 years claims experience in a managed care environment preferred.

Responsibilities

• Supervise a team of claims personnel.
• Manage claims inventory for multiple companies according to state and federal guidelines utilizing inventory management systems and reports.
• Team with other departments to resolve departmental/employee issues.
• Review and update policies and procedures.
• Manage the work behaviors of all subordinate staff.
• Coach, counsel and reward as appropriate to individual performance.
• Deliver monthly/annual performance reviews.
• Interviewing, hiring, and training employees.
• Planning, assigning and directing work.
• Appraising performance.
• Rewarding and disciplining employees.
• Addressing complaints and resolving problems.

Benefits

• Medical, dental, vision, disability, life, and business travel insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• Paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: High school or GED