Welcome page Returning Candidate? Log back in! Supervisor of Claims Job Locations US-Remote Job ID 2024-3572 Category Claims Operations Posted Date 1 day ago(10/4/2024 10:22 AM) Type Regular Full-Time Overview

Now is the time to join us! 

 

We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Responsibilities

Who are you?

 

The Claims Supervisor will oversee their team of processors and make sure that claims are processed timely and accurately. Other duties include, reviewing inventory daily, oversee the renewal process, respond to escalated issues, respond to DOI complaints and CMS letters. The supervisor will assist the manager on day to day projects and work with the manager on New Client Implementation.

 

In this role you will wear many hats, but your knowledge will be essential in the following:  

Manage Claims Inventory to maintain zero backlogMaintain a daily understanding of demand of claims vs supply of production capacity in order to adjust, prioritize claims productionEnsure End to End Quality of Claims processed to meet Claims Control blueprint and client SLAsAssist Claims team with questions and escalationsManage and Respond to Account Management/Client Inquiries&Issues related to delivery for book of business.Identify and encourage continuous improvement ideas oriented towards efficiency and effectiveness of daily workParticipate/Consult for Claims Delivery on New Client ImplementationResponsible for renewal management for clients and claims review for membersIdentify, prioritize training and certification of team to maintain best practice knowledge, client intimacy and claims processing proficiency.Respond/and/or Coordinate response to PPO inquiries as received from Team/NetworkSecondary review for high dollar audits as per the High Dollar RACILead operational rigor with teams including team meetings and action plansOwnership for Change Notice review and adjustment to SOPs, procedures and training for client driven plan design changesPayroll/ overtime/incentive managementProject and Initiatives as assigned or ownedTeam recognition

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Qualifications

What you bring to the Personify Health team:

 

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

Required – High School Diploma or GED equivalentPreferred – Associate’s Degree in Business

You also take pride in offering the following Core Skills, Competencies, and Characteristics:

Required – Senior Processor or higher 5+ yearsPreferred – 3+ years previous Supervisor experience

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

 

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

 

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $54,000 to $64,000. Note that salary may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits.

 

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

 

#WeAreHiring #PersonifyHealth

 

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.

 

Application Deadline: Open until position is filled.

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