Supervisor, Claims Processing

2 weeks ago


California, United States Inland Empire Health Plan Full time
What you can expect

Find joy in serving others with IEHP We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience

The Supervisor, Claims Processing – Medi-Cal provides daily oversight of claims staff, business processes and inventory management. Ensures the claims team follows state/federal regulations and standard operating procedures. Develops best practices to optimize claim processing quality. Evaluates professional skills of team members and provide appropriate work assignments. Resolve claim payment issues and quality oversight. Assist in hiring and training new team members in their job responsibilities. Monitors individual and team performance to ensure quality and performance objectives are met. Assist in employee performance evaluation, coaching and professional development activities to improve performance efficiency.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

CalPERS retirement
457(b) option with a contribution match
Generous paid time off- vacation, holidays, sick
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Paid life insurance for employees with additional options
Short-term, and long-term disability options
Pet care insurance
Flexible Spending Account – Health Care/Childcare
Wellness programs that promote a healthy work-life balance
Career advancement opportunities and professional development
Competitive salary with annual merit increase
Team bonus opportunities

Education & Experience

Four (4) years medical claims processing experience, at least two (2) years of experience in a supervisory capacity leading a team.
Three (3) years of experience in a managed care environment.
Experienced in benefit and financial matrix interpretation.
Experience preferably in an HMO or Managed Care setting.
High School diploma or GED required.
Bachelor's degree from an accredited institution preferred.

Key Qualifications

A thorough understanding of claims industry and customer service standards. Knowledge in CMS, DHMC and DHCS regulatory guidelines including AB1455. Extensive knowledge of ICD-9, ICD-10, CPT, and Revenue Codes.
Solid understanding of the DHCS, DMHC and CMS rules and regulations governing claims adjudication practices and procedures desired.
Principles and techniques of supervision and training.
Knowledge of medical terminology and understanding of healthcare claims.
Analytical skills with emphasis on time management, data base maintenance, spreadsheet manipulation, and problem solving.
Strong writing, organizational, project management, and communication skills proficiency required.
Excellent interpersonal/communication skills.
Must have a high degree of patience and ability to lead a large team of professionals.

Start your journey towards a thriving future with IEHP and apply TODAY

  • California, United States Inland Empire Health Plan Full time

    What you can expectFind joy in serving others with IEHP We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experienceThe Supervisor, Claims Processing – Medi-Cal provides daily oversight of claims staff, business processes and inventory management. Ensures the claims team follows...


  • California, United States Inland Empire Health Plans Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Supervisor, Claims Processing – Medi-Cal provides daily oversight of claims staff, business processes and inventory management. Ensures the claims team...


  • California, United States Inland Empire Health Plan Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Supervisor, Claims Processing – Medi-Cal provides daily oversight of claims staff, business processes and inventory management. Ensures the claims team...


  • Concord, California, United States CCMSI Full time

    Overview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs,...


  • California, United States Selby Jennings Full time

    A Brief OverviewThis position is responsible for the operational leadership and claims performance of the property, casualty, or physical damage claims within the AgriBusiness (AG) Operations. This includes administrative management, managing operational expenses, and measurement of individual/team performance, productivity, service, and results.What you...


  • California, United States Selby Jennings Full time

    A Brief OverviewThis position is responsible for the operational leadership and claims performance of the property, casualty, or physical damage claims within the AgriBusiness (AG) Operations. This includes administrative management, managing operational expenses, and measurement of individual/team performance, productivity, service, and results.What you...


  • California, United States Inland Empire Health Plan Full time

    The Supervisor, Claims Processing – Medi-Cal provides daily oversight of claims staff, business processes and inventory management. Ensures the claims team follows state/federal regulations and standard operating procedures. Develops best practices to optimize claim processing quality. Resolve claim payment issues and quality oversight. Assist in hiring...


  • Concord, California, United States CCMSI Full time

    Overview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs,...


  • Irvine, California, United States CCMSI Full time

    Overview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs,...


  • Bakersfield, California, United States Embark Behavioral Health Full time

    Overview: Insurance Services Supervisor Pay: $30.00 - $35.00 The Insurance Services Supervisor will oversee an Insurance Services team to effectively implement and complete the billing and collections processes for Embark BH programs. The primary responsibilities for this role include building a cohesively effective billing and collections team to ensure...


  • Irvine, California, United States CCMSI Full time

    Overview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs,...


  • Folsom, California, United States Gallagher Full time

    About Us: Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our...

  • UI Claims Analyst

    3 days ago


    Costa Mesa, California, United States Experian Full time

    Job Description As the world of work evolves, human capital management must keep pace.  Employers have been seeking scalable, client-focused alternatives.  In response, Experian has brought together the industry’s experts to offer the best of the best– a suite of specialized solutions delivering unmatched service, trusted experience, and...


  • Pleasanton, California, United States AbbVie Full time

    Job Description The Case Manager oversees claims of adverse events incurred by patients treated with an AbbVie medical device. They serve as the main point of contact for healthcare professionals, patients and internal stakeholders, with a heavy focus on gathering necessary information and documentation to verify claims and determine financial compensation....


  • Folsom, California, United States Gallagher Full time

    About Us: Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our...


  • Folsom, California, United States Gallagher Full time

    About Us: Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our...


  • Folsom, California, United States Gallagher Full time

    About Us: Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our...


  • Irvine, California, United States Crowell & Moring Full time

    Job Description Crowell & Moring LLP is an international law firm with offices in the United States, Europe, MENA, and Asia that represents clients in litigation and arbitration, regulatory and policy, and transactional and corporate matters. The firm is internationally recognized for its representation of Fortune 500 companies in high-stakes litigation and...

  • Laboratory Supervisor

    4 weeks ago


    California, United States Bureau Veritas Switzerland AG Full time

    Select how often (in days) to receive an alert: Laboratory Supervisor - Petroleum Sector Date: Oct 3, 2023 Do you believe in the power of teamwork and sharing ideas? Do you take pride in delivering exceptional quality and service with everything you do? Do you seek out ideas for improving the status quo? If you want to make a difference and love being...


  • Glendale, California, United States Public Storage Full time

    Job Description We are looking for an Accounts Payable Supervisor to join our team.  The Supervisor will oversee and guide the Account Payable team, including assisting staff with problem resolution, training, and process improvement.  The Supervisor will support the Accounts Payable Manager in monitoring daily activity.   KEY RESPONSIBILITIES Ensure...