Supervisor, Claims

Health Plans Inc•Remote, US,

21h•$75,000 - $85,000•Hybrid

About The Position

HPI is unique. A respected industry leader that’s been serving customers for over 40 years, we’re known for our innovation and growth. Our experience has given us our expertise, but our forward-thinking, entrepreneurial spirit has given us our strong reputation. As a third-party administrator, we offer a suite of health and benefit solutions to employers. By joining HPI, you’ll contribute to ideas that make a real difference for employers and employees nationwide. There isn’t a challenge we won’t accept and we’re looking for people who have a passion to take it on. Not just a job—a mission.

Requirements

High school diploma or equivalent education
Three to five years’ of claims processing experience
Proficient in Microsoft Office, including Word, Excel, Outlook and PowerPoint

Responsibilities

Oversee a dedicated unit of Claim Examiners and Claim Seniors.
Oversee the daily team operations and plan for future workflow and scheduling.
Mentor Claims Seniors and staff to better coordinate the daily production, turnaround time and work quality of claims processing while meeting company goals.
Coordinate new business group implementation and testing on new business.
Set policy & procedures and work with the auditing team on audit appeals.
Oversee work setup queues working with the Technical Resource Unit.
Work with Senior Claims Examiners to create and manage department work schedules.
Complete weekly turnaround time reports.
Attend new business implementation meetings.
Assist in supervisor level phone calls.
Review and maintain department policies and procedures.
Partner with department manager to identify team inefficiencies and solutions.
In conjunction with department manager, hire, train, and manage staff within the claims teams.
Monitor employee performance; write and/or deliver annual reviews.
Work with department manager regarding staff performance, development and training functions.
Advise department manager of issues raised by staff; suggest actions to improve processing or resolve issues.
Work with appropriate subject matter experts to provide necessary training within the team.
Work with Account Services to implement and test new business and support renewing business within the team.
Work with Technical Resource Unit to audit claim system build.
Manage relationships with internal and external business associates.
Process threshold claims to a maximum dollar level of $100,000.
Process Medicare demand payments.
Handle special projects as assigned by the Manager.