Claims Supervisor

7 days ago


Fontana CA United States Inland Empire Health Plan Full time
Job Title: Supervisor, Claims Processing

At Inland Empire Health Plan, we are committed to delivering exceptional healthcare services to our members. We are seeking a highly skilled and experienced Supervisor, Claims Processing to join our team.

Job Summary:

The Supervisor, Claims Processing will be responsible for overseeing the daily operations of the claims team, ensuring compliance with state and federal regulations, and developing strategies to improve claim processing quality. This role requires strong leadership and analytical skills, with the ability to motivate and develop a team of professionals.

Key Responsibilities:
  • Supervise and manage the claims team to ensure timely and accurate processing of claims.
  • Develop and implement processes to improve claim processing quality and efficiency.
  • Collaborate with the Claims Quality Assurance and Training teams to identify areas for improvement and develop training programs.
  • Monitor and track claim inventory and workflow to ensure compliance with regulatory requirements.
  • Provide coaching and guidance to team members to improve performance and achieve quality objectives.
  • Assist in the development and implementation of policies and procedures to ensure compliance with regulatory requirements.
  • Participate in regulatory audits and provide subject matter expertise on claims processing procedures.
Requirements:
  • Four (4) years of medical claims processing experience, with at least two (2) years of supervisory experience.
  • Three (3) years of experience in a managed care environment.
  • Extensive knowledge of ICD-9, ICD-10, CPT, and Revenue Codes.
  • Strong analytical and problem-solving skills, with the ability to work in a fast-paced environment.
  • Excellent communication and interpersonal skills, with the ability to lead and motivate a team.
What We Offer:
  • Competitive salary and annual merit increase.
  • CalPERS retirement plan.
  • 457(b) option with a contribution match.
  • Generous paid time off, including vacation, holidays, and sick leave.
  • State-of-the-art fitness center on-site.
  • Medical insurance with dental and vision coverage.
  • Paid life insurance and short-term and long-term disability options.
  • Pet care insurance and flexible spending account.
  • Wellness programs and career advancement opportunities.
How to Apply:

If you are a motivated and experienced professional looking for a challenging and rewarding role, please submit your application today.


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