Claims Production Supervisor

HealthPartners•Bloomington, MN

About The Position

Demonstrate a commitment to the Corporate and Department mission and vision. Manage and monitor the expedient and accurate adjudication of claims and adjustments and/or refunds. Organize and oversee the overall resolution of written and verbal inquiries from internal and external members. Provide the guidance, motivation, and support necessary to enable individual growth and teamwork in line with individual needs, department objectives, and marketplace expectations. The supervisor oversees staff and has authority to hire, transfer, lay off, promote, discipline, discharge, train, reward, and review employee performance. The role ensures compliance with organizational and departmental policies and procedures and directs or provides training for permanent and temporary Claims Department staff. The supervisor builds high-performance teams through performance measurements, goal setting, monitoring, and evaluation; motivates staff to meet or exceed quality and production expectations; and works with Technical Support Coordinators to determine the level of claims requiring audit for each examiner. The role requires independent, logical decision-making in a fast-paced, continuously changing environment. The supervisor has latitude in allocating the work team to meet customer service objectives and communicates decisions affecting the entire department to appropriate team members.

Requirements

Bachelor’s degree in management, business, health care, human relations, or a related area; or an associate degree with at least two years of leadership/management experience; education may be waived with a minimum of four years of leadership/management experience.
Detailed understanding of the health care industry, including insurer operations and provider network arrangements.
Ability to interact with all levels of staff and external customers.
Ability to establish and maintain effective, courteous, and confidential relationships with staff, providers, and members.
Strong interpersonal and human relations skills.
Ability to work independently and as a team member.
Ability to lead others through change and adapt flexibly to changing work direction.
Ability to foster enthusiasm, pride in work, and commitment to organizational goals and vision.
Ability to establish a work environment free from harassment and discrimination.
Effectiveness in evaluating employees and providing feedback.
Ability to identify training needs and provide learning opportunities.
Ability to make verbal presentations and lead discussions.
Advanced analytical and problem-solving skills.
Experience interpreting and implementing technical data and contracts.
Logical, principle-based decision-making and ability to meet deadlines.
Strong organizational and time-management skills.
Working knowledge of continuous quality improvement (CQI) processes and principles.
Computer knowledge.
General knowledge of accounting principles.
Ability to make logical decisions independently in a fast-paced, continuously changing environment.

Nice To Haves

Bachelor’s degree in management, business, health care, human relations, or a related area; or an associate degree with at least four years of supervisory experience in a health care setting.
Two to four years of HealthPartners claims experience and familiarity with HealthPartners goals and objectives.
Experience processing claims and general knowledge of various processing systems.
Working knowledge of Collective Bargaining Agreements.
Project management experience.

Responsibilities

Supervise staff, including exercising authority to hire, transfer, lay off, promote, discipline, discharge, train, reward, and review employee performance.
Ensure compliance with organizational and departmental policies and procedures.
Ensure, direct, and/or provide training for permanent and temporary Claims Department staff.
Promote teamwork and encourage high morale and motivation.
Develop high-performance work teams using performance measurements, individual goal setting, and monitoring and evaluation of results.
Work with staff to develop and implement individual and departmental goals and objectives.
Motivate staff to meet or exceed department quality and production expectations.
Identify staff performance issues and prepare and implement action plans to resolve problems.
Work with Technical Support Coordinators to determine the level of claims requiring auditing for each examiner.
Manage and monitor timely, accurate adjudication of claims, adjustments, and/or refunds.
Organize and oversee the resolution of written and verbal inquiries from internal and external members.
Allocate team work to meet customer service objectives and communicate decisions affecting the entire department to appropriate team members.