Supervisor Claims

Highmark Health•NY, Working at Home - New York, NY

3d•$58,100 - $90,000•Remote

About The Position

This position supervises and coordinates the day-to-day activities of claims processing or claims adjustment units. The units respond to inquiries from internal teams, members, providers, and account representatives across all markets. The role oversees employees primarily in Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, and Wyoming counties in New York. The position is designated as remote office-based, with a physical work site required. Travel requirements are 0%–25%.

Requirements

High school diploma or GED.
At least 2 years of experience in a claims environment.
At least 1 year of experience leading or supervising others.
Knowledge of multiple processing systems and workflows.
Knowledge of claims processing methodologies.
Ability to interpret government regulations.
Knowledge of Highmark products.

Nice To Haves

Bachelor’s degree.

Responsibilities

Communicate effectively.
Effectively supervise all assigned personnel.
Coordinate distribution of claims backlogs for regular and overtime work across departments and companywide.
Monitor and manage daily inventories to ensure adequate staffing and resources are available.
Serve as a subject matter expert on benefit plans and claims processing issues, implementation of new groups and products, and transition meetings.
Research quality issues and respond to error assessments.
Routinely monitor business processes and recommend and design process improvements to improve accuracy and timeliness or eliminate manual effort.
Perform other duties as assigned or requested.
Protect covered information, cardholder data, and confidential customer information, and comply with HIPAA and company data-security policies.
Comply with the company’s Code of Business Conduct, applicable laws and regulations, company policies, and training requirements.