Claims Processing Specialist

The Claim Supervisor is responsible for the oversight and management of health claims processing and will have direct management of a team of claim examiners and/or support roles. The team is responsible for the accurate processing of health care claims on behalf of the employer plan and members benefits and will set and monitor claims examiner productivity goals and claim quality metrics.
This position requires a very detail oriented individual who is flexible and comfortable with assessing projects and assigning priorities. This position includes interaction with internal and external customers to research and provide detailed responses and reporting. This key team member manages a small team of individuals and the right candidate should be comfortable in leading a team.
Key to the success of this position includes: attention to detail, strong organizational skills and a good understanding of Microsoft Office tools
Role and Responsibilities:

• Managing Daily Team Operations
• Managing team of up to 20 resources
• Team mentoring & coaching individual associates who may fall below desired performance
• * Manage attendance & incentives for the team.
• Handle escalations on process issues that cannot be resolved by agents
• Monitoring and ensuring closure of daily/weekly and monthly deliverables
• Managing SLA, Daily Reporting, Agent's leave planning
• Maintain a strong knowledge of products and services for customers that we are servicing
• Monitor random cases to improve quality, minimizing errors and track operative performance
• Continuously contribute towards process improvement
• Assign tasks, supervise, mentor and complete timely performance evaluations.
• Provide technical training and career development for staff
• Conduct remote and side by side monitoring of member contacts to ensure quality assurance standards are met.
• Consistently communicate changes such as policies, procedural and overall performance as a team and one-on-one.
• Communicate any necessary changes to work schedules to meet business needs.
• Support team morale, team building, and employee trust through frequent feedback and recognition.
• Accountable for the daily/weekly/monthly activities of team members.
• Ensure required training courses are completed timely.

Qualifications

• 4-5 years of Team Lead or Supervisory experience with 2/3 years’ experience with claims processing
• Demonstrate strong work ethics by maintaining confidentiality of information.
• Must have effective supervisory skills: planning, organizing, monitoring and coaching.
• Requires specialized knowledge where problems, assignments and / or duties are difficult but related.
• Must be able to think and work independently, but structured by broad principles and / or procedures.
• High aptitude for working with numbers.
• Must work well under pressure and make decisions quickly
• Have excellent interpersonal and communication skills and ability to address conflict proactively
• Strong computer knowledge
• High School Diploma or higher (will be verified and you will need to provide documentation during on-boarding process)

Job Types: Full-time, Contract, Temporary

Pay: $23.55 - $25.00 per hour

Expected hours: 40 per week

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Claims Processor: 3 years (Preferred)
• Health Insurance: 3 years (Preferred)
• Team Lead: 4 years (Preferred)

Work Location: In person

Salary : $24 - $25