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A&G Team Supervisor

2 months ago

California, United States Mitchell Martin Inc. Full time

Position: Supervisor for the Customer Solution Center Appeals and Grievances

Location: Los Angeles, CA - Hybrid Schedule

Employment Type: Full Time/Permanent

Overview: The Supervisor will be responsible for managing the Appeals & Grievances team, ensuring comprehensive investigations, assisting with intricate cases, collaborating with various internal departments, and upholding established policies and procedures.

Key Responsibilities:

  • Ensure the team achieves key performance indicators (KPIs) and adheres to regulatory standards.
  • Provide guidance to staff on complex issues faced by members and providers.
  • Conduct regular one-on-one meetings with team members.
  • Develop and implement effective policies, procedures, and training programs.
  • Prepare for audits and suggest necessary corrective measures.

Required Qualifications:

Experience:

  • Mandatory: 3-5 years in healthcare grievances and appeals, compliance, claims, or call center operations; 2-3 years in a supervisory role.
  • Desirable: Experience in Managed Health, particularly in customer service, appeals and grievances, or claims processing.

Essential Skills:

  • Strong data management and organizational abilities.
  • In-depth knowledge of regulatory and accreditation standards.
  • Exceptional communication and interpersonal skills.
  • Proficiency in Microsoft Office Suite.

Educational Background:

  • Preferred: Master's or Bachelor's Degree.