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MetroPlusHealth · 20 hours ago

Behavioral Health (BH) Claims Supervisor

New York, NY

Full-time

Hybrid

Entry, Mid Level

$65K/yr - $76K/yr

2+ years exp

MetroPlusHealth is seeking a Behavioral Health Claims Supervisor to oversee personnel involved in the adjudication of behavioral health-related medical claims. The role includes supervising the BH Claims Unit, processing complex claims, ensuring training materials are current, and participating in special projects as required.

Financial ServicesHealth CareHealth InsuranceInsuranceLife Insurance

Responsibilities

Supervise the day-to-day workload of the BH Claims Unit including assignment of tasks

Identify issues and problems with claims submissions

Identify system processing issues

Process complex, difficult, and non-routine claims for multiple lines of business

Ensure that training manuals are current, and that policies and procedures are followed correctly

Plan, develop, and conduct training programs for staff

Provide input to the ASP Manager related to the development and performance of employees

Participate in special projects as required

Represent the BH Claims Unit in the absence of the ASP Manager

Qualification

HMO claims processingMedicaid policies knowledgeClaims Examiner dutiesData entryVerbal skillsTrustFunctional/Technical skillsWritten skillsIntegrityCustomer Focus