Claims Examiner Supervisor

JOB SUMMARY

• Supervise a team of claims personnel.
• Manage claims inventory for multiple companies according to state and federal guidelines utilizing inventory management systems and reports.
• Team with other departments to resolve departmental/employee issues.
• Review and update policies and procedures.
• Manage the work behaviors of all subordinate staff. Coach, counsel and reward as appropriate to individual performance. Deliver monthly/annual performance reviews.

• Supervise a team of claims personnel.
• Manage claims inventory for multiple companies according to state and federal guidelines utilizing inventory management systems and reports.
• Team with other departments to resolve departmental/employee issues.
• Review and update policies and procedures.
• Manage the work behaviors of all subordinate staff. Coach, counsel and reward as appropriate to individual performance. Deliver monthly/annual performance reviews.

If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Direct Reports (titles)
Claims Leads, Claims Examiners, Project Coordinators, Adjusters Indirect Reports (titles) N/A

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• General office equipment experience
• Must have an excellent understanding of health and managed care concepts and their application in the adjudication of claims.
• Strong working knowledge of ICD.
  9.CM, CPT, HCPCS, RBRVS coding schemes and medical terminology.

• High School Diploma or Equivalent
• 5-6 years Supervisory/Management experience preferred.
• 2-3 years claims experience in a managed care environment preferred.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to work in sitting position, use computer and answer telephone
• Ability to travel (minimal)
• Light physical effort (lift up to 10lbs). Regularly needs to be able to bend, stoop and reach to file.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Office Work Environment

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition…