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Universal Healthcare MSO, LLC · 1 day ago

Claims Supervisor- Bakersfield 1.1

Bakersfield, CA

Full-time

Onsite

Senior Level

$28.47/hr - $35.58/hr

5+ years exp

Universal Healthcare MSO, LLC is seeking a Claims Supervisor to provide hands-on leadership and operational oversight within the Claims Department. This role involves supervising staff, managing claims processing, and ensuring compliance with regulatory requirements while fostering process improvements and operational efficiency.

Hospital & Health Care

Responsibilities

Supervise daily claims operations, ensuring timely, accurate processing of claims and encounters

Monitor claims inventory and production reports to maintain productivity and quality standards

Coach, train, and provide performance feedback to claims staff

Support adherence to claims workflows, policies, and procedures

Ensure compliance with regulatory, contractual, and health plan requirements

Identify staff training needs and coordinate appropriate support

Collaborate with Enrollment and internal departments to ensure accurate claim processing

Assist in troubleshooting system issues and support process improvement initiatives

Provide feedback to management on workflow, productivity, and operational challenges

Participate in departmental meetings and support cross-functional initiatives as needed

Assist with onboarding and performance management of claims staff

Ensure staff have the tools and resources needed to perform their job functions

Perform other related duties as assigned

Qualification

Claims processing experienceSupervisory experienceCoding certificationRegulationsClaims systems experienceOrganizational skillsAnalytical skillsMicrosoft ExcelMicrosoft WordCommunication skills

Required

High School Diploma or GED required

Minimum of 5 years of experience processing professional and institutional claims within a managed care environment, preferably in an IPA or medical group setting

Strong knowledge of professional and institutional claim processing

Knowledge of fee schedules and pricing methodologies for inpatient, outpatient, ancillary, and professional claims

Familiarity with CMS, DMHC, and DHS regulations

Understanding of health plan financial responsibility structures and provider contract interpretation

Strong organizational, analytical, and communication skills

Proficiency in Microsoft Excel, Word, and email

Possession of a valid driver's license

Proof of state-required auto liability insurance