MetroPlusHealth · 5 hours ago
Claims Supervisor
New York, NY
Full-time
Hybrid
Mid, Senior Level
$60K/yr - $70K/yr
3+ years expMetroPlusHealth is seeking a Claims Supervisor to oversee the daily Medicare claims processes. This role involves managing claims operations staff, ensuring accurate processing of claims, and improving claims-related processes through reporting and training.
Financial ServicesHealth CareHealth InsuranceInsuranceLife Insurance
Responsibilities
Liaises between claims staff and stakeholders, including providers, members, and internal Metro Plus Health staff
Participates in claims related workgroups designed to address claims issues and improve processes
Prepares routine reports for the manager on productivity, error rates, complaint rates, financial recordkeeping, and other activities
Identifies system processing issues and assist with the root cause analysis process
Develops, implements, and maintains claims operation policies, procedures and workflow
Assists with the planning, development, and training of claims operations staff
Provides input related to the development and performance of employees to Manager
Manages daily inventory queues and assigns resources to ensure inventory is processed timely and accurately
Monitors daily inventory and assigned claims queues for production and issue identification
Generates claims operations dashboard and reports related to inventory and productivity
Participates in special projects as needed
Other duties as assigned
Qualification
Required
High School Diploma and minimum 7 years of claims operations experience in a healthcare field required; or
Associate's degree and minimum 5 years of claims operations experience in a healthcare field; or
Bachelor's degree and minimum 3 years of claims operations experience in a healthcare field
Knowledge of claims payment methodologies and policies
Knowledge of CMS Regulations
Proficient in reporting applications, such as Excel, Access or SQL preferred
Integrity and Trust
Customer Focus
Functional/Technical skills
Written/Oral Communication
Ability to work in a dynamic and fast paced environment
Company
MetroPlusHealth
MetroPlusHealth provides health insurance to individuals, families, and small businesses.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Julie Myers
Deputy Chief Medical Officer
Laura Santella-Saccone
Chief Marketing & Brand Officer
Recent News
2025-07-17
Company data provided by crunchbase