Claims Supervisor responsible for supervising claims team and coordinating timely and accurate review of all patient medical claims and invoices received for payment determination by performing the following duties. Located in Miramar, Florida. Hybrid schedule   All duties and responsibilities are to be performed in accordance with VITAS Healthcare Corporation’s policies, procedures, guidelines, contractual commitments, and regulatory compliance.
  • Oversees daily operations of the claims department. • Trains, determines, and prepares work schedules and procedures, assigns and reviews workflow of claims staff. • Ensures the efficient and timely processing of claims by effectively managing the workflow processing and completion within the department. • Implements and maintains quality control processes to ensure accuracy and consistency in claims processing. • Advises claims team in resolving complex or escalated claims issues by providing guidance on claims handling procedures, policy interpretation, and compliance. • Identifies and resolves problems, errors and inconsistencies and suggests appropriate corrective procedures. • Communicates and coordinates claims and accounting policies, practices, and procedures with department(s), programs, and vendors / providers. • Establishes a positive work environment, encouraging professional development, and addressing any staff performance issues or grievances with management. • Issues written and oral instructions. • Observes and evaluates employees and work procedures to ensure quality standards, improve efficiency and service is met.   • Assists manager in employee evaluations and recommendations regarding personnel actions such as new hire requests and discharges, to ensure proper staffing. • Analyze key performance indicators (KPIs) to assess the productivity of the claims department and assists in preparing regular performance reports for management. • Attends meetings, training activities, courses and all other work-related activities as required. • Performs related duties as required. This position description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.
 
 
  QUALIFICATIONS
  To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. 
  Experience: • 3 -5 years’ experience working in healthcare with medical claims processing.  • 2 or more years in supervisory or leadership role within claims • Knowledge of CMS reimbursement guidelines • Strong analytical and problem-solving skills  • Ability to effectively apply the policies and practices involved in the claims and human resource’s function. • Ability to supervise staff in a positive and productive manner by motivating, developing, and managing employees as they work. • Ability to utilize and administer the disciplinary action process through coaching and counseling to improve performance or terminate employment. • Ability to communicate tactfully, verbally and in writing with department heads, managers, coworkers, and vendors to resolve problems and negotiate resolutions. • Working knowledge of computers, internet access, and the ability to navigate within an automated systems as well as a variety of software packages such as Outlook, Excel, and Word.  • Knowledge of coding structures (CPT, HCPCS, Revenue Codes, ICD10, etc.).
 
  Education:  Associate’s or Bachelor’s degree in:  Healthcare Administration, Business Administration, Accounting or related field from an accredited college or university or the international equivalent preferred.
  Certification & Licensure: None required for this position.
  Reasonable Accommodations: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.