Medical Claims Operations Supervisor at MultiPlan

MEDICAL CLAIMS OPERATIONS SUPERVISOR (REMOTE) IN WORK FROM HOME AT MULTIPLAN

Employee Type: Full-Time

Location: Work From Home

Job Type: Insurance Management

Experience: Not Specified

JOB DESCRIPTION

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client’s needs and tailoring innovative healthcare cost management solutions.

Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talented individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine!

As a Medical Claims Supervisor, you will lead a team within a production environment within operations. An ideal candidate will have at least two years as a people manager and three years’ experience in healthcare insurance, billing, or claims processing. Our core business hours are Monday Friday 8:00 AM to 5:00 PM.

JOB SUMMARY:

The Supervisor is responsible for managing the day-to-day planning and operations of the Team. This position is also responsible for serving as a resource for problem solving; staffing, service evaluation and enhancement; and policies/procedures and to ensure efficient operations in a fast-paced environment.

JOB ROLES AND RESPONSIBILITIES:

• Manage daily operations and processes within the department by monitoring employee workflow and inventory, including distribution of claims/work, when applicable.
• Train, mentor, motivate, support and oversee staff performance; including coaching when needed.
• Monitor compliance with all departmental policies, procedures, and workflows as well as interface with all other internal teams regarding procedural compliance.
• Monitor departmental and individual performance metrics and take proactive action when necessary on a timely basis to maintain desired workflow outputs; acting upon variances when applicable.
• Develop and implement workflow changes to improve service and production efficiency of the department; this may include collaboration with other teams.
• Collaborate with the training team and all other internal teams to implement new and revised procedures; which may include suggested system changes or enhancements.
• Train, mentor, motivate and oversee staff performance; including coaching when needed. moved up
• Manage and review complex and/or difficult claims or issues to determine best outcome.
• Partner with internal and external contacts to achieve effective communications and maximum savings.
• May act as a liaison in monitoring and supporting specific client, provider or departmental assignments through reporting and relationship building.
• Oversight or research on special projects as assigned.
• Select, develop, and evaluate staff to ensure the efficient operation of department.
• Collaborate, coordinate, and communicate across disciplines and departments.
• Ensure compliance with HIPAA regulations and requirements.
• Demonstrate Company’s Core Competencies and values held within.
• Please note due to the exposure of PHI sensitive data — this role is considered to be a High Risk Role.
• The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE:

The individual impacts efficiency and effectiveness of team operations. This is a people management role that has the authority to initiate and communicate some HR actions (training, new processes, coaching, mentoring, etc.) but for others, such as hiring, salary adjustments, position change, termination, and other disciplinary actions, the individual collaborates on such issues with the next level. The individual must have the ability to exercise discretion and independent judgment to judiciously act in situations where specific guidelines may not apply.

JOB REQUIREMENTS (Education, Experience, and Training):

• Minimum high school diploma and three (3) years’ related experience in healthcare or managed care industry; preferably with claims processing, auditing, and/or customer service.
• Minimum 2 years’ experience in a leadership role
• Required licensures, professional certifications, and/or Board certifications as applicable.
• Knowledge of claims processing and procedure.
• Knowledge of provider billing and collection practices.
• Knowledge of medical coding systems and commonly used medical data resources preferred.
• Communication (written, verbal, listening) problem solving, organization, time management, leadership, and coaching skills
• Knowledge of effective negotiations principles
• Ability to convey information clearly, effectively and objectively
• Ability to communicate and process detailed verbal and written instructions.
• Able to demonstrate teamwork, organization, prioritization, and time management.
• Ability to be detail oriented to ensure accuracy, including mathematical calculations
• Ability to maintain commitment to providing a level of service within established standards
• Ability to lead, motivate, manage, coach and mentor others
• Ability to elicit trust and credibility with all levels of the organization
• Ability to identify issues and determine appropriate course of action for resolution
• Ability to adjust/alter workflow and schedule to meet deadlines in a fast-paced environment.
• Ability to analyze data and arrive at a logical conclusion.
• Ability to make decisions using limited or incomplete data, when necessary situations arise.
• Ability to work independently and handle confidential information
• Ability to manage multiple projects at the same time.
• Ability to use software and hardware related to job responsibilities, including MS Word and MS Excel spreadsheets and database software
• Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone

We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.

Your benefits will include:

• Medical, dental, and vision coverage (low copay & deductible)
• Life insurance
• Short- and long-term disability
• 401(k) + match
• Generous Paid Time Off
• Paid company holidays
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Summer Hours we get off two hours early with pay every Friday beginning Memorial Day to Labor Day company-wide!
• Winter Hours- we get off early two hours with pay every third Friday with pay company-wide!