Colorado Access · 3 weeks ago
Supervisor of Claims Research
11100 E Bethany Dr, Aurora, CO 80014, USA
Full-time
Hybrid
Mid, Senior Level
$78K/yr - $90K/yr
3+ years expColorado Access is a Colorado-based company focused on improving the health of the state by providing quality, affordable care. The Supervisor of Claims Research will oversee the claims research specialists, ensuring quality assurance and effective operations while monitoring workflows and maintaining departmental policies.
FitnessHealth CareNon Profit
Responsibilities
Provides supervision and coordination of work performed by the claim research specialists. Provides feedback, coaching and counseling regarding performance
Responsible for maintaining quality assurance of all claim research activities. Performs and evaluates the results of quality reviews and takes appropriate, timely action to resolve identified concerns
Establishes and monitors workflows and inventory. Makes appropriate adjustments based on work volume, projects and other changes that impact day to day operations
Supervises the research of claims as well as special projects as requested with E-Plus
Responsible for creation and oversight of claim research reports and dashboards for internal departmental monitoring, quality and reports due to the State or other contract holders
Communicates key information within the department and to key stakeholders to ensure good coordination and effective operations
Develops and maintains policies and procedures and maintains claim research correspondence and configuration within the claim research tracking tool
Participates in performance and compliance audits conducted by the State or other contract holders
Qualification
Required
Bachelor's degree in business, Healthcare or related field
Equivalent combination of experience and/or education may substitute with a preference for at least five years progressive relevant work experience
Minimum of three years' experience in processing health insurance claims; including at least two years of Medicaid and Medicare claims experience
Previous supervisory experience preferred
Solid knowledge of managed care/health insurance claims including HCPC, CPT, and ICD10 coding for Medicaid and Medicare and commercial claims
Thorough knowledge of claims processing including subrogation, reinsurance, appeals, etc
Strong written and verbal communications skills
Demonstrates support for the company's mission, vision, and values
Strong organizational, project and time management skills
Ability to work independently and propose solutions to issues identified in daily operations
Strong knowledge of computer applications and Microsoft Office
A valid driver's license and proof of current auto insurance will be required for any position requiring driving
Preferred
Previous supervisory experience
Benefits
Medical, dental, vision insurance that starts the first day of the month following start date.
Supplemental insurance such as critical illness and accidental injury.
Health care and dependent care flexible spending account options.
Employer-paid basic life insurance and AD&D (employee, spouse and dependent).
Short-term and long-term disability coverage.
Voluntary life insurance (employee, spouse, dependent).
Paid time off
Retirement plan
Tuition reimbursement (based on eligibility).
Annual bonus program (based on eligibility, requirements and performance).
Company
Colorado Access
Colorado Access are a nonprofit health plan that provides access to behavioral and physical health services for Coloradans.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
A
April Abrahamson
Chief People and Talent Development Officer
Jaime Moreno
Chief Communications and Members Experience Officer
Recent News
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