MetroPlusHealth · 12 hours ago
Behavioral Health (BH) Claims Supervisor
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
Required
Bachelor's Degree required
Minimum of two (2) years' experience in HMO claims processing; or a satisfactory equivalent combination of education, training, and experience
Well versed in all the duties and responsibilities of the Claims Examiner position including data entry and system adjudication of BH claims
Knowledge of Medicaid policies, as well as enrollment policies procedures
Integrity and Trust
Customer Focus
Functional/Technical skills
Excellent verbal and written skills
Must be able to work in a professional manner with employees, management, and providers
Company
MetroPlusHealth
MetroPlusHealth provides health insurance to individuals, families, and small businesses.
Funding
Current Stage
Late StageLeadership Team
Recent News
2025-07-17
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