Supervisor, Claims Processing
3 weeks ago
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.
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.
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
-
Supervisor, Claims Processing
2 weeks ago
California, United States Inland Empire Health Plan Full timeWhat 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...
-
Supervisor, Claims Processing
2 months ago
California, United States Inland Empire Health Plans Full timeWhat 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...
-
Claims Specialist
3 days ago
California, United States CorVel Corporation Full timeThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote position. ESSENTIAL...
-
Agriculture Claims Manager
2 months ago
California, United States Selby Jennings Full timeA 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...
-
Agriculture Claims Manager
2 months ago
California, United States Selby Jennings Full timeA 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...
-
Agriculture Claims Manager
3 days ago
California, United States Selby Jennings Full timeA 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...
-
Claims Assistant
2 weeks ago
California, United States CorVel Corporation Full timeThe Claims Assistant will assist and support the claims staff in the set-up and administration of workers' compensation claims/case management and other tasks depending on the specific needs of the customers. This is a remote opportunity. ESSENTIAL JOB DUTIES & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless), and...
-
Claims Assistant
6 days ago
California, United States CorVel Corporation Full timeThe Claims Assistant will assist and support the claims staff in the set-up and administration of workers' compensation claims/case management and other tasks depending on the specific needs of the customers. This is a hybrid work arrangement. ESSENTIAL JOB DUTIES & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless),...
-
Claims Assistant
3 days ago
California, United States CorVel Corporation Full timeThe Claims Assistant will assist and support the claims staff in the set-up and administration of workers' compensation claims/case management and other tasks depending on the specific needs of the customers. This is a remote opportunity. ESSENTIAL JOB DUTIES & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless), and...
-
Claims Assistant
3 days ago
California, United States CorVel Corporation Full timeThe Claims Assistant will assist and support the claims staff in the set-up and administration of workers' compensation claims/case management and other tasks depending on the specific needs of the customers. This is a hybrid work arrangement. ESSENTIAL JOB DUTIES & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless),...
-
Senior Claims Specialist
3 weeks ago
California, United States CorVel Corporation Full timeWe are seeking a 4850 Sr. Claims Specialist for our Southern California Team. The Sr. Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and...
-
Senior Claims Specialist
3 days ago
California, United States CorVel Corporation Full timeWe are seeking a 4850 Sr. Claims Specialist for our Southern California Team. The Sr. Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and...
-
CA Claims Specialist
3 weeks ago
California, United States CorVel Corporation Full timeThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote opportunity. ESSENTIAL...
-
CA Claims Specialist
3 days ago
California, United States CorVel Corporation Full timeThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote opportunity. ESSENTIAL...
-
CA Claims Specialist
3 weeks ago
California, United States CorVel Corporation Full timeThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote position. ESSENTIAL...
-
CA Senior Claims Specialist
2 weeks ago
California, United States CorVel Corporation Full timeThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to...
-
CA Senior Claims Specialist
2 days ago
California, United States CorVel Corporation Full timeThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to...
-
Senior Claims Specialist
2 weeks ago
California, United States CorVel Corporation Full timeWe are seeking a Sr. WC Claims Specialist for our Southern California Team. The Sr. Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and...
-
Senior Claims Specialist
3 days ago
California, United States CorVel Corporation Full timeWe are seeking a Sr. WC Claims Specialist for our Southern California Team. The Sr. Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and...
-
CA Claims Specialist
2 weeks ago
California, United States CorVel Corporation Full timeThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic indemnity claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote opportunity. ESSENTIAL FUNCTIONS &...