Claims Management Supervisor
7 days ago
We are seeking a highly skilled Claims Management Supervisor to join our team at the APWU Health Plan. This is a critical role that requires strong leadership and claims management skills.
Job Summary:The Claims Management Supervisor will be responsible for managing the claims inventory and reviewing claims adjustments in a timely and accurate manner. The ideal candidate will have experience in claims processing, subrogation, and Medicare/Medicaid billing. We offer a competitive salary of $85,000 - $110,000 per year, depending on experience.
Key Responsibilities:- Manage the claims inventory and review claims adjustments in a timely and accurate manner
- Supervise and direct employees in analyzing and adjusting claims, including OIC/COB, SNF, DRG, Travel Claims, Medicare, Tricare, Foreign Currency, Managed Care, PPO, Workers Compensation, and subrogation
- Identify discrepancies in claim processing and payment, determine if overpayments/underpayments exist, and reprocess claims accordingly
- Develop and implement processes to improve claims processing efficiency and accuracy
- Maintain relationships with external vendors and stakeholders
- Bachelor's degree (or equivalent experience)
- 4+ years of experience in a supervisory or leadership role in claims management
- Experience in QNXT processing, subrogation, Medicare, Medicaid, and OIC/COB
- Strong decision-making and problem-solving skills
- Excellent communication and leadership skills
The APWU Health Plan offers a dynamic work environment, opportunities for professional growth and development, and a competitive benefits package. If you are a motivated and experienced claims management professional looking for a new challenge, we encourage you to apply.
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