Claims Processing Supervisor

All Care Health Headquarters, Grants Pass, OR, US

5 days ago Requisition

Salary Range: $26.00 To $32.00 Hourly

All Care Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and telecommute, remote work, and flexible schedule options.

The Claims Processing Supervisor ensures that all internal and external departmental performance requirements are consistently met. This role oversees the day-to-day activities of the claims processing team, determines work assignments and efficient workflows to meet contractual obligations, and serves as a hands-on resource for staff on training, questions, and claims processing best practices.

• Provide one on one support, initial training for new hires and monthly mandatory training sessions for all claims processing staff.
• Establish and maintain a professional, supportive, provider service-oriented workplace culture with high standards of individual and team performance.
• Maintain production and quality monitoring logs and reports for both individual and overall departmental performance.

• Assist in maintaining and monitoring internal audit procedures to ensure staff compliance with policies
• Support internal audit procedures to ensure staff compliance with company policies and procedures.
• Ensure desktop procedures are followed consistently and provide retraining as needed.
• Maintain and support department policy guidelines for HIPAA and PHI compliance.
• Review, create, maintain, and update desktop procedures and reference materials for claims processing staff.
• Assist in developing and updating relevant policies, procedures, and training materials.
• Learn and maintain a working understanding of the job duties of all positions supervised.
• Organize workflow and delegate responsibilities to reporting staff, including coverage during absences.
• Monitor team productivity and provide regular, constructive feedback.
• Identify and resolve workplace issues, including attendance and performance concerns.
• Conduct annual performance evaluations for direct reports.
• Prepare clear, detailed documentation of employee conversations and disciplinary actions.
• Communicate needed system changes, process improvement ideas, and staff concerns to the direct supervisor.
• Effectively communicate to your direct supervisor any needed system changes, ideas for department process improvements, concerns, and staff issues.
• Respectfully takes direction from the Sr. Claims Processing Manager and or the VP, Claims Administration & Payment Integrity
• Demonstrates effective behavior and communicates in a respectful and professional manner
• Maintains punctual, regular and predictable attendance.
• Works collaboratively in a team environment with a spirit of cooperation.
• Meets all required training including those listed in Relias Learning Module System (LMS).
• Performs other duties as assigned.

This position does not have any on call responsibilities.

Directly supervises 9 to 11 (nine to eleven)employees in the Claims department. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. 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 duties.

• High school Diploma or equivalent required.
• Bachelor's degree (BA) from a four-year college or…