Texas Children's Hospital
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Claims Supervisor
role at
Texas Children's Hospital .
Job Description 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, managing and directing the activities of a team of Claims Examiners and Claims Benefits Specialists. You will handle claims processing concerns and issues that require a high degree of knowledge, creativity, research, and communication with internal and external resources to achieve timely resolution. You will ensure resources are utilized efficiently in accordance with Claims Administration objectives that consistently promote internal and external customer quality and satisfaction. You will assist the Manager of the Claims Department by monitoring the daily workflow for team members, acting as a communication conduit between the Claims Examiners, Claims Benefits Specialists, and management.
Job Duties & 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.
Provides daily management support to Claims Examiners and Claims Benefits Specialists.
Participates in new‑hire interviews and makes recommendations for candidate selection.
Regularly monitors performance using the weekly productivity log to ensure staff are meeting production goals and identifies coaching or training opportunities.
Monitors available resources and system reports to facilitate day‑to‑day operations, ensuring staff have the necessary tools and information.
Maintains visibility, walking around periodically to perform live monitoring and provide support to those needing assistance.
Provides daily monitoring of production stats.
Provides front‑line answers to questions and research.
Performs post‑training follow‑up and review.
Participates in quality initiatives and performance management.
Initiates and completes the check‑run process.
Skills & Requirements
High school diploma or GED
Minimum 5 years of claims processing experience
About Us Founded in 1996, Texas Children’s Health Plan is the nation’s first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children’s Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. The Health Plan serves more than 375,000 members with a network of over 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children’s Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children’s without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected federal, state, province or local status unrelated to the performance of the work involved.
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Claims Supervisor
role at
Texas Children's Hospital .
Job Description 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, managing and directing the activities of a team of Claims Examiners and Claims Benefits Specialists. You will handle claims processing concerns and issues that require a high degree of knowledge, creativity, research, and communication with internal and external resources to achieve timely resolution. You will ensure resources are utilized efficiently in accordance with Claims Administration objectives that consistently promote internal and external customer quality and satisfaction. You will assist the Manager of the Claims Department by monitoring the daily workflow for team members, acting as a communication conduit between the Claims Examiners, Claims Benefits Specialists, and management.
Job Duties & 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.
Provides daily management support to Claims Examiners and Claims Benefits Specialists.
Participates in new‑hire interviews and makes recommendations for candidate selection.
Regularly monitors performance using the weekly productivity log to ensure staff are meeting production goals and identifies coaching or training opportunities.
Monitors available resources and system reports to facilitate day‑to‑day operations, ensuring staff have the necessary tools and information.
Maintains visibility, walking around periodically to perform live monitoring and provide support to those needing assistance.
Provides daily monitoring of production stats.
Provides front‑line answers to questions and research.
Performs post‑training follow‑up and review.
Participates in quality initiatives and performance management.
Initiates and completes the check‑run process.
Skills & Requirements
High school diploma or GED
Minimum 5 years of claims processing experience
About Us Founded in 1996, Texas Children’s Health Plan is the nation’s first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children’s Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. The Health Plan serves more than 375,000 members with a network of over 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children’s Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children’s without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected federal, state, province or local status unrelated to the performance of the work involved.
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