Moda Health
Supervisor Medical Claims – Moda Health
Overview
Provides supervision, coaching and support to Claims Processors. Organizes staff, sets goals, establishes procedures, and continues to ensure claims are processed promptly and accurately. Measures and evaluates performance and results. Coaches and trains as required to achieve goals of quality and efficiency. This is a full-time work-from-home role. Responsibilities
Supervises staff giving daily work direction, vacation scheduling, monitoring attendance, conducting performance reviews, and hiring and training new employees. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems. Controls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality. Assists with planning by analyzing amount of work and type of work, assigns and sets priorities and decides on retraining needs. Motivates and coaches the processors by reviewing results with them, conveys what is expected, asks for suggestions, and fulfills training needs. Use and manipulate Excel files. Other duties as assigned. Qualifications
College degree or equivalent work experience. 2 – 4 years medical claims processing experience, including 1 year as Senior/Lead processor. Computer proficiency in company’s systems and Word and Excel. Strong verbal, written and interpersonal communication skills. Strong analytical, problem solving and decision-making skills. Ability to work well under pressure with frequent interruptions and shifting priorities. Ability to come in to work on time daily. Maintain confidentiality and project a professional business image. Benefits
Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Pay
Pay Range: $58,747.10 - $73,433.88 annually, DOE. This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Working Conditions & Contact With Others
Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need. Internal collaboration with staff in Underwriting, Professional Relations, Claims Support, Accounting, and IT. External interaction with providers, policyholders, insureds, and brokers. Equal Opportunity
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.
#J-18808-Ljbffr
Provides supervision, coaching and support to Claims Processors. Organizes staff, sets goals, establishes procedures, and continues to ensure claims are processed promptly and accurately. Measures and evaluates performance and results. Coaches and trains as required to achieve goals of quality and efficiency. This is a full-time work-from-home role. Responsibilities
Supervises staff giving daily work direction, vacation scheduling, monitoring attendance, conducting performance reviews, and hiring and training new employees. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems. Controls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality. Assists with planning by analyzing amount of work and type of work, assigns and sets priorities and decides on retraining needs. Motivates and coaches the processors by reviewing results with them, conveys what is expected, asks for suggestions, and fulfills training needs. Use and manipulate Excel files. Other duties as assigned. Qualifications
College degree or equivalent work experience. 2 – 4 years medical claims processing experience, including 1 year as Senior/Lead processor. Computer proficiency in company’s systems and Word and Excel. Strong verbal, written and interpersonal communication skills. Strong analytical, problem solving and decision-making skills. Ability to work well under pressure with frequent interruptions and shifting priorities. Ability to come in to work on time daily. Maintain confidentiality and project a professional business image. Benefits
Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Pay
Pay Range: $58,747.10 - $73,433.88 annually, DOE. This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Working Conditions & Contact With Others
Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need. Internal collaboration with staff in Underwriting, Professional Relations, Claims Support, Accounting, and IT. External interaction with providers, policyholders, insureds, and brokers. Equal Opportunity
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.
#J-18808-Ljbffr