What are the responsibilities and job description for the Remote Supervisor, Claims Resolution & Provider Recovery | WFH position at Get It - Professional Services?
Job Overview
We are looking for an accomplished Supervisor of Provider Claims Resolution & Recovery to join our dedicated team in a remote capacity. This pivotal position requires a proactive leader to guide a team of professionals, ensuring precise and timely resolution of provider claims while contributing significantly to the success of our organization.
Key Responsibilities
Joining our esteemed organization opens doors for professional development, enabling you to enhance your leadership skills and progress your career in a supportive and mission-driven environment.
Company Culture And Values
We pride ourselves on fostering a mission-driven culture, dedicated to improving the health and well-being of our members, and making a meaningful impact in our community. We emphasize teamwork, learning, and innovation in our workplace.
Compensation And Benefits
We offer a competitive compensation package that includes comprehensive health insurance, a robust benefits plan, and the flexibility of a remote work arrangement. Join us to advance your career while enjoying a work-life balance.
Employment Type: Full-Time
We are looking for an accomplished Supervisor of Provider Claims Resolution & Recovery to join our dedicated team in a remote capacity. This pivotal position requires a proactive leader to guide a team of professionals, ensuring precise and timely resolution of provider claims while contributing significantly to the success of our organization.
Key Responsibilities
- Lead and mentor a high-achieving team, overseeing daily operations and providing essential guidance, support, and constructive feedback.
- Ensure the efficient and accurate resolution of complex claims disputes, appeals, and adjustments, fostering an environment of responsive service.
- Analyze the claims resolution process to identify trends and implement strategic improvements aimed at enhancing operational efficiency and accuracy.
- Facilitate clear and effective communication with providers, internal departments, and stakeholders to promptly address claim-related issues.
- Stay updated on and enforce compliance with all pertinent regulations, including CMS, DHMC, and DHCS guidelines.
- Cultivate a positive and collaborative atmosphere that encourages team growth and professional development.
- Proven experience in navigating healthcare claims, with a minimum of four years in a Managed Care setting, emphasizing claims processing and provider payment appeals.
- Demonstrated leadership capability with at least one year in a supervisory role.
- Strong analytical and problem-solving abilities, with a knack for interpreting complex data and formulating effective solutions.
- Excellent communication and interpersonal skills, adept at engaging a diverse range of stakeholders both internally and externally.
- Strong organizational and time-management skills, with the ability to prioritize tasks and manage multiple projects simultaneously.
- Proficiency in Microsoft Office Suite, particularly advanced skills in Excel.
- High School Diploma or GED is required.
- Experience with Medi-Cal and/or Medicare programs, as well as familiarity with ICD-9, CPT, and Revenue Codes, will be considered advantageous.
- Previous experience in an HMO or Managed Care environment is a plus.
Joining our esteemed organization opens doors for professional development, enabling you to enhance your leadership skills and progress your career in a supportive and mission-driven environment.
Company Culture And Values
We pride ourselves on fostering a mission-driven culture, dedicated to improving the health and well-being of our members, and making a meaningful impact in our community. We emphasize teamwork, learning, and innovation in our workplace.
Compensation And Benefits
We offer a competitive compensation package that includes comprehensive health insurance, a robust benefits plan, and the flexibility of a remote work arrangement. Join us to advance your career while enjoying a work-life balance.
Employment Type: Full-Time
