Supervisor, Reimbursement Account Claims
About The Position
This position oversees the Reimbursement Claims Processing Team, which facilitates, processes, and substantiates claims for the Departmental Product Portfolio. The portfolio includes Flexible Spending Accounts (FSA), Health Reimbursement Arrangements (HRA), Health Savings Accounts (HSA), Transit and Parking, Student Loan, Tuition Reimbursement, and Wellness Benefits. The supervisor manages daily team activities, including hiring, onboarding, training, performance appraisals, team meetings, employee development, administration of company policies, and team recommendations. The position coordinates and monitors personnel and workflow to support timely completion, production standards, and regulatory compliance. It develops and monitors claims workflows, metrics, audits, policies, and procedures, and addresses barriers, backlogs, and processing problems through process improvements. The role leads system enhancements, release testing, process-improvement initiatives, and other assigned projects. It also provides client, broker, and member support as needed, ensures policy and operational compliance, maintains knowledge of relevant laws and regulations, and protects member privacy. Regular and reliable attendance is expected. Other functions may be assigned by management.
Requirements
- Five or more years of related work experience, including three or more years in healthcare or reimbursement claims processing operations.
- Prior experience supervising or managing people and/or projects, or indirectly leading teams.
- Thorough ongoing knowledge and application of IRC Sections 105, 125, and 129 regulations and compliance requirements applicable to benefit administration.
- Ability to make prudent, well-researched critical decisions and understand their impact on the department and company.
- Good organizational skills and ability to prioritize assignments.
- Ability to establish and maintain constructive working relationships with internal personnel at all levels and external constituents.
- General PC skills, including Microsoft Outlook and Word.
- Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer.
- Ability to travel across the Health Plan service region for meetings and/or training as needed.
Nice To Haves
- Intermediate to advanced Excel skills.
Responsibilities
- Manage and oversee daily claims processing team activities, including hiring, onboarding, training, performance appraisals, team meetings, employee development, administration of company policies, and team recommendations.
- Plan, coordinate, prioritize, monitor, and report on assigned personnel activities.
- Evaluate workflow and inventory levels to ensure production and timely completion in accordance with performance standards and regulatory requirements.
- Develop, implement, and monitor claims operations, including workflows, performance metrics, internal audits, policies, and procedures, to support effectiveness, efficiency, and compliance.
- Identify and remove barriers to productivity, quality, cost effectiveness, timeliness, and member satisfaction.
- Report and address backlogs or inventory concerns with management; identify processing problems and implement solutions through process-improvement initiatives.
- Lead system enhancements, release testing, process-improvement projects, and other special projects assigned by department management.
- Provide direct client, broker, and member support as necessary, including special projects, audits, education and training, troubleshooting, and problem resolution.
- Ensure LBS policies comply with applicable laws and corporate personnel policies.
- Support the Lifetime Healthcare Companies’ mission and values, adhere to the Corporate Code of Conduct, and lead according to Lifetime Way values and beliefs.
- Maintain member privacy in accordance with corporate privacy policies and procedures.
- Maintain knowledge of relevant legislative and regulatory mandates and ensure activities comply with those requirements.
- Conduct periodic staff meetings and distribute and educate staff on departmental and Ethics/Compliance information in a timely manner.
- Maintain regular and reliable attendance.
- Perform other functions as assigned by management.
Benefits
- Group health and/or dental insurance may be available as part of the total rewards package.
- Retirement plan may be available as part of the total rewards package.
- Wellness program may be available as part of the total rewards package.
- Paid time away from work may be available as part of the total rewards package.
- Paid holidays may be available as part of the total rewards package.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
