Claims Supervisor

Texas Children's Medical Center•Houston, TX

45d

About The Position

We’re looking for a Supervisor of the Claims Department, someone who’s ready to grow with our company. In this position you will serve as a front-line supervisor by managing and directing the activities of a team of Claims Examiners and Claims Benefits Specialists. To handle claims processing concerns and issues requiring a high degree of appropriate knowledge, creativity, research, and communication with internal and external resources to achieve timely resolution. To ensure resources are utilized efficiently, in accordance with Claims Administration objectives that consistently promotes internal and external customer quality and satisfaction. Assists the Manager of the Claims Department by monitoring the daily workflow for team members in reference to claim volume, receipts, and processing. To act as a communication conduit between the Claims Examiners, Claims Benefits Specialists, and management Think you've what it takes?

Requirements

Required H.S. Diploma or GED
5 years of claims processing experience

Responsibilities

Provides direct supervision of the daily operations for Claims Examiners and Claims Benefits Specialists.
Proactively identifies and solves problems with timely resolution of complex issues referred by Claims Examiners and Claims Benefits Specialists. Identifies the most appropriate course of action for problem resolution and effectively communicates the plans to those impacted. These issues frequently require research, collaboration with other departments, communications with external resources, and response creation.
Provides daily management support to Claims Examiners and Claims Benefits Specialists.
Participates in new-hire interviews and makes recommendations for candidate selection.
Regularly monitors Claims Examiners and Claims Benefits Specialists using the weekly productivity log to ensure Claims Examiners and Claims Benefits Specialists are performing within Claims Administration’s production goals and identify any individual coaching or group training for long-term performance improvement and teamwork. Identify opportunities and recognize positive behaviors of Claims Examiners and Claims Benefits Specialists.
Monitors available resources, system reports to facilitate the day-to-day operations to ensure that Claims Examiners and Claims Benefits Specialists are productive and have the necessary tools and information to perform their job. Responds to internal system trouble notifications and coordinates the involvement of other departments to facilitate problem resolution.
Maintains visibility to Claims Examiners and Claims Benefits Specialists. Walks around periodically to perform live monitoring of Claims Examiners and Claims Benefits Specialists and provides support to those needing assistance.
Provides daily monitoring for Claims Examiners and Claims Benefits Specialists production stats.
Provides front line for answers to questions and research.
Performs post training follow up and review.
Participates in quality initiatives and performance management.
Initiates and completes check run process.