Claims Processing Supervisor

Job Summary

Responsible for the operations of one or more claims processing units, including timely and proper adjudication of claims in accordance with contractual benefits. Responsible for providing leadership and direction to employees. Directs the processing of insurance claims to meet operation, financial, and service requirements. Develops and executes strategic and operational business plans for the departments. Coordinates department operations and modifications with other areas of the organization.

Essential Responsibilities

• Works on issues of broad scope.
• Receives assignments as objectives with the processes necessary to fulfill those goals.
• Requires considerable planning and direction setting.
• Develops and directs work schedules and monitors workflow to achieve established goals and objectives.
• Responsible for recommending changes in guidelines, procedures, and policies.

Job Qualifications

Minimum Qualifications

• Bachelor's degree in related fields and six (6) years of overall experience
• In lieu of a bachelor’s degree, equivalent work experience of three (3) years may be substituted for a total of nine (9) years’ experience.
• At least One (1) years of experience in leadership role and managing team
• At least Three (3) years of experience in medical billing (OR) Medical coding experience with ambulance billing (or) Ancillary claims processing

Additional Requirements

• Requires knowledge of claims processing and working knowledge of another functional area.
• Minimum three (3) years of management in a claims processing environment preferred.

Preferred Qualifications

• Healthcare experience
• Certification in CPC (or) CPB - Ambulance billing