1199SEIU Benefit and Pension Funds
Job Title
Supervisor – Balance Billing Department – 1199SEIU Benefit and Pension Funds
Responsibilities
Supervise staff in the Balance Billing Department, monitor staff time and attendance via ADP.
Evaluate employee performance; provide coaching, feedback, and corrective action; identify training needs and develop performance improvement plans.
Collaborate with management to develop, revise, and implement policies, procedures, and workflows to ensure compliance with internal standards and external regulations.
Assist in overseeing No Surprises Act open negotiations and Independent Dispute Resolution processes, ensuring regulatory timelines and accuracy standards.
Provide guidance on complex claims, review and approve payments exceeding staff thresholds, and update systems in accordance with Fund policies.
Negotiate No Surprises Act claims with out-of-network providers to resolve disputes prior to escalating to IDR.
Monitor production, aging, and escalation reports to ensure timely action.
Develop and maintain reporting structures for No Surprises Act metrics; prepare quantitative and qualitative reports to management.
Maintain BeneFAQ topics and communicate with members, providers, attorneys, and collection agencies regarding payment status.
Perform additional duties and projects as assigned by management.
Qualifications
Bachelor’s degree in Business Management, Health, or related field.
Minimum 3 years experience in claims processing with in-depth knowledge of medical claims processing and terminology.
At least 1 year of leadership experience in a healthcare benefits environment.
Strong management skills: coaching, mentoring, motivating staff, implementing improvement plans.
Excellent math and analytical skills with ability to translate data into reports.
Knowledge of eligibility rules, Coordination of Benefits, and 1199SEIU Benefit and Pension Fund systems (QNXT, DMS V3, RightFax); experience with fee negotiations and settlements preferred.
Proficiency in Microsoft Access, Excel, and Word; PowerPoint knowledge preferred.
Excellent research, interpersonal, oral, and written communication skills.
Ability to work under pressure and prioritize tasks in a high-volume environment.
Employment Type Full Time, Permanent, Hybrid
Compensation Competitive based on experience.
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Supervisor – Balance Billing Department – 1199SEIU Benefit and Pension Funds
Responsibilities
Supervise staff in the Balance Billing Department, monitor staff time and attendance via ADP.
Evaluate employee performance; provide coaching, feedback, and corrective action; identify training needs and develop performance improvement plans.
Collaborate with management to develop, revise, and implement policies, procedures, and workflows to ensure compliance with internal standards and external regulations.
Assist in overseeing No Surprises Act open negotiations and Independent Dispute Resolution processes, ensuring regulatory timelines and accuracy standards.
Provide guidance on complex claims, review and approve payments exceeding staff thresholds, and update systems in accordance with Fund policies.
Negotiate No Surprises Act claims with out-of-network providers to resolve disputes prior to escalating to IDR.
Monitor production, aging, and escalation reports to ensure timely action.
Develop and maintain reporting structures for No Surprises Act metrics; prepare quantitative and qualitative reports to management.
Maintain BeneFAQ topics and communicate with members, providers, attorneys, and collection agencies regarding payment status.
Perform additional duties and projects as assigned by management.
Qualifications
Bachelor’s degree in Business Management, Health, or related field.
Minimum 3 years experience in claims processing with in-depth knowledge of medical claims processing and terminology.
At least 1 year of leadership experience in a healthcare benefits environment.
Strong management skills: coaching, mentoring, motivating staff, implementing improvement plans.
Excellent math and analytical skills with ability to translate data into reports.
Knowledge of eligibility rules, Coordination of Benefits, and 1199SEIU Benefit and Pension Fund systems (QNXT, DMS V3, RightFax); experience with fee negotiations and settlements preferred.
Proficiency in Microsoft Access, Excel, and Word; PowerPoint knowledge preferred.
Excellent research, interpersonal, oral, and written communication skills.
Ability to work under pressure and prioritize tasks in a high-volume environment.
Employment Type Full Time, Permanent, Hybrid
Compensation Competitive based on experience.
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