Claims supervisor - united states, batna

summary:

supervises the day to day operations of the claims processing area. assists in establishing fee schedules and pricing/billing guidelines and procedures.

 

scope of work:

supervise the receipt, processing, calculation, payment and reporting of monthly claims submitted by providers in compliance with contractual requirements, regulations, and agency policies and procedures. supervise claims staff and implement plans to achieve goals, establish priorities and set realistic completion dates. provide telephone assistance and problem resolution to providers as needed. conduct claims team meetings, identify and coordinate training needs, and administer performance evaluations on all supervised staff. assist in developing division goals and measurement systems of performance indicators. train, coach, and evaluate assigned staff on performance expectations. participate in hiring and termination procedures. computer proficiency and technical aptitude with the ability to utilize ms office including excel spreadsheets interpersonal, time management and organizational skills. ensures all direct reports execute objectives by the use of a developmental plan/ninety (90) day plan and regular performance reviews; posting productivity, quality and deadline results. other duties as assigned

 

education and experience:

high school diploma or ged 2 years or more of supervisory experience in an claim processing setting.

 

work environment:

 

on site - in an office setting

 

 

how to apply:

 

please go to our career site to get more information about this position and to apply using the following link:

 

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refer claims for medical claim reviewconduct detailed technical training of non claims processing claims staffsupervise a team of claims adjusterssupervising the processing of claimshelp improve claims processing workflowreview and analyze reports on claims adjudication and claims auditingensure timely handling of all claimsmaintain periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by clientensure all claims processing documentation isresolve complex escalated claims processing issueshelp insurance companies mitigate claims expense and reduce claims cycle timeensure all conveyances and claimshandle all personal injury claimsdemonstrate understanding of automated claims processingreduce overall cost of processing claimsprovide formal training on claims processing guidelinesexecute appropriate claims activities to ensure consistent delivery of quality of claims serviceperform system testing of claims processing systemhandle the most complex, difficult claims and adjust controversial claimshelp improve claims processing workflows, efficiencies

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