Apply on Employer Site

MetroPlusHealth · 23 hours ago

Claims Supervisor

New York, NY

Full-time

Onsite

Mid, Senior Level

$60K/yr - $70K/yr

3+ years exp

MetroPlusHealth is seeking a Claims Supervisor to oversee Medicare claims processes and manage the Claims Operation staff. The role involves ensuring accurate and timely processing of claims, training staff, and preparing reports on productivity and error rates.

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

Claims operations experienceClaims payment methodologiesCMS Regulations knowledgeReporting applications proficiencyTrustFunctional/Technical skillsDynamic work environment adaptabilityIntegrityCustomer FocusWritten/Oral Communication