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Healthcare Claims Supervisor
2 months ago
EDI Staffing is seeking a skilled Healthcare Claims Supervisor to oversee our Claims Department. This role is pivotal in ensuring precision and cost efficiency in medical claims processing for our clients.
Key Responsibilities:- Leadership: Direct the claims and repricing teams to maintain optimal workflow.
- Client Communication: Regularly update clients on claims progress and timelines.
- Network Management: Investigate PPO networks and direct contracts to maximize savings on claims.
- Deadline Management: Ensure timely processing of claims as promised to clients.
- Quality Assurance: Conduct quality reviews of claims to minimize processing errors.
- Audit Coordination: Identify claims for auditing by the Medical Team based on established criteria.
- Interdepartmental Collaboration: Work closely with other department supervisors to adhere to operational processes.
- Negotiation: Recognize claims with minimal discounts for potential negotiation.
- Procedure Implementation: Develop and introduce new procedures for emerging business lines.
- Training: Educate and cross-train staff on claims handling processes.
- Client Reporting: Provide regular updates to clients regarding their claims.
- Claims Review: Assess all rejected claims from healthcare providers.
- Eligibility Preparation: Prepare eligibility files for healthcare claims.
- Collaboration: Engage with other departments to resolve claims-related issues.
- Staff Development: Onboard new employees and cross-train existing personnel.
Our client offers a competitive compensation package, including:
- Comprehensive health and dental insurance
- Complimentary vision, life, and hospital gap insurance
- 12 paid holidays annually
- Generous Paid Time Off
- 401K plan with company matching up to 4%
- Salary commensurate with experience
