Cambia Health Solutions, Inc | Supervisor of Claims Production OR

3 weeks ago


portland, United States Cambia Health Solutions, Inc Full time

Supervisor Claims Production
Remote within Oregon, Idaho, Utah

Build a career with purpose. Join our

Cause to create a person-focused and economically sustainable health care system.

As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us. This role supports members, providers and various internal departments by mentoring staff, monitoring workflow, maintaining performance measures and ensuring timely and quality claims processing while adhering to State, Federal and company guidelines.


What You Bring to Cambia:


Qualifications:
  • Bachelor's degree (Preferred)

  • 3 years of experience related to claims processing, preferred in the healthcare industry

  • Demonstrated leadership/supervisory experience, or the equivalent combination of education and experience.


Skills and Attributes:

* You'll lead a team of claims professionals, setting priorities, overseeing work outputs and timelines, and developing productivity, quality, and service standards to ensure exceptional performance.

* You'll possess strong analytical skills, identifying problems, trends, and developing solutions to implement a course of action, while also communicating effectively with all levels of the organization, both verbally and in writing.

* You'll have a deep understanding of the insurance industry, related regulations, and mandates, as well as experience working in a high-volume claims processing center, with a proven track record of managing performance and creating an environment for service excellence.

* You'll be able to organize, plan, and prioritize assignments within multiple projects, participating in and managing well-defined projects with minimal guidance, and leveraging your knowledge of medical terminology and/or claims coding to inform your decision-making.

* As a leader, you'll be responsible for developing and training your team, including employees in multiple locations or working remotely, and fostering a culture of collaboration, innovation, and customer-centricity to drive results and achieve business objectives.

What You Will Do at Cambia

* You'll lead and manage a team of claims professionals, assigning and prioritizing work, setting goals, and coordinating daily activities, while also providing regular updates and communication through 1:1 and team meetings.

* You'll monitor individual and team results, ensuring work is completed in a timely manner, in accordance with department standards and procedures, and in compliance with medical policy and guidelines, and identify areas for process improvements.

* You'll act as a resource for staff and others, escalating issues and partnering with other departments to resolve them, and participate in the selection process, provide ongoing coaching and performance management, and write performance reviews.

* You'll facilitate the maintenance of reference manuals, work procedures, and procedural guidelines, and complete special projects as assigned, including leading division projects, implementing process improvement projects, and analyzing data to present to departmental leadership.

* You'll oversee claims processing, ensuring accuracy and timeliness according to company timelines, and provide support services, including scheduling, reporting to management, meeting facilitation, and issue resolution, while also participating on project teams to recommend solutions and translate business requirements.

#LI-remote

FTEs Supervised

5-20



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