3RD PARTY CLAIMS PROCESSING SUPERVISOR

BrightSpring Health Services Corporation; Louisville (KY); A distancia; USD 60.000 - 86.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive Pay

Health, Dental, Vision & LifeInsurance

Company-Paid Short & Long-TermDisabilt

Flexible Schedules & PTO

Tuition Reimbursement

Employee Discount Program & DailyPay

401k

Pet Insurance

Descripción de la vacante

PharMerica in Louisville is seeking an experienced Administrative and Clerical Supervisor to support multiple locations and processes across the organization.

You will manage staff, set goals with the 3rd Party Claims Manager, monitor performance, and ensure SOX and compliance while maintaining strong relationships with payers and colleagues. This role offers flexible scheduling and remote options with focus on accuracy and payroll oversight.

Formación

• Associates degree, 4 year college, technical degree or 4+ years equivalent experience.
• Minimum 3+ years direct supervisory experience.
• Experience in 3rd party billing or healthcare billing preferred.
• AS400 experience or familiarity.
• MS Office proficiency and ability to handle confidential information.
• Strong communication skills and detail orientation.

Responsabilidades

• Coordinate with 3rd Party Claims Manager to set goals, track performance and audits.
• Maintain professional relationships with staff, payers and stakeholders.
• Assign work and monitor queues, including resolution and billing tasks.
• Monitor quality of work and ensure compliance.
• Lead meetings to discuss performance metrics and progress toward goals.
• Escalate trends to Manager and update staff on process changes.
• Mentor Team Leads and supervise attendance and payroll processes.
• Ensure SOPs are updated and SOX compliance is maintained.
• Manage workload fairness and staff training needs.

Conocimientos

MS Office

Confidentiality

Educación

Associates degree

4 year college

Technical degree

4+ years equivalent experience

Herramientas

AS400

Descripción del empleo

Job ID

2026-196946

Job Locations

US-KY-LOUISVILLE

Line of Business

PharMerica

Position Type

Full-Time

Our Company

PharMerica

Overview

Are you the super-star multitasker type, strong in administration skills? Our Administrative and Clerical positions support the business from multiple locations and via various functions across the nation.

Schedule

Monday - Friday

Evening and Weekends

Remote Positions

Benefits

• Competitive Pay
• Health, Dental, Vision & Life Insurance
• Company-Paid Short & Long-Term Disability
• Flexible Schedules & Paid Time Off
• Tuition Reimbursement
• Employee Discount Program & DailyPay
• 401k
• Pet Insurance

Responsibilities

• Works in conjunction with the 3rd Party Claims Manager to establish specific associate goals, department wide goals, performance tracking and quality assessment audits.
• Establish and maintain professional and effective relationship with staff, peers, payers and other stakeholders.
• Provides associates assignments and work queues on a daily and/or weekly basis. Including resolution, billing, and appropriate distribution of work.
• Monitors quality of work performed by all associates, including interaction and compliance.
• Holds regularly scheduled meetings with staff to discuss performance metrics and ensure employees are on track to meet their goals.
• Report to Manager any trends occurring with payers and/or processes
• Updates staff with communications and process changes as directed by 3rd Party Claims Manager, Director or Senior Management and insures compliance.
• Handles escalated calls from customers and payers to ensure proper resolution.
• Mentor and provide oversight of Team Leads and Associate II staff to insure they are adequately communicating staff training needs, shadowing staff when assigned, performing monthly quality assessment reviews, and taking a lead role in any special projects that may be assigned by Supervisor or Manager.
• Manages staff attendance and time sheets for payroll (Kronos) system. Assures staff is meeting attendance policies and reports any variations to Manager.
• In conjunction with feedback provided by Team Lead and/or Associate, monitor work performance including quality
• Ensure assignments are fair and balanced based on Team Lead/Associate level skills sets.
• Works to update, create and/or maintain Standard Operations Procedures for the department.
• Ensures Sarbanes Oxley (SOX) compliance on all variance, write-off and convert exception reports inclusive of adequate signatures are obtained.
• Proper storage of completed documents per Compliance policies.
• Performs other tasks as assigned.
• Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
• Works to update, create and/or maintain Standard Operations Procedures for the department.

Education/Learning Experience

• Required: Associates degree, 4 year college , technical degree or 4+ years equivalent experience

Work Experience

• Required: 3+ years direct supervisory experience
• Desired: 3rd Party Billing or collections/billing experience in the healthcare industry, AS400 computer systems experience or Pharmacy Technician.

Skills/Knowledge

• Required: Proficiency in MS Office Products (Excel, Word) and Basic computer knowledge
• Required: Ability to maintain confidentiality
• Desired: AS400 Computer Systems Experience

Behavior Competencies

• Required: Excellent communication skills, both written and oral
• Required: Problem solving and detail oriented
• Required: Strong time management, organizational skills and self-starter
• Required: Strong attendance and leadership

About our Line of Business

PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.