Claims CQI Supervisor & QA Training Lead

HealthCare Talent; Irvine (CA); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Competitive compensation

Excellent benefits package

Room for advancement

Job summary

HealthCare Talent is assisting in hiring a Supervisor for Claims (CQI) in Irvine, California. The Supervisor will oversee the operations of the QA staff, ensuring compliance with Medi-Cal and Medicare guidelines in the Claims Department.

This role offers competitive compensation and a robust benefits package, along with opportunities for professional growth in a supportive working environment.

Qualifications

• High school diploma or equivalent required; some college preferred.
• 3+ years of experience in a managed care environment.
• Substantial knowledge of medical claims administration.
• Experience directing work and supervisory experience preferred.

Responsibilities

• Train and supervise QA staff to adhere to Medi-Cal and Medicare guidelines.
• Monitor staff to ensure claims auditing timelines are met.
• Serve as backup for claims processing as needed.
• Schedule unit meetings for program updates and staff reviews.
• Plan work for staff and assign daily claims.
• Set or recommend work performance standards.

Skills

Diffusing emotional situations

Professional communication

Positive influence

Clear instruction

Problem troubleshooting

Task management

Objective feedback

Interpersonal relationship building

Computer skills

Planning and organizing

Education

High school diploma or equivalent

Some college preferred

Tools

Claims processing systems

Spreadsheets

Job description

HealthCare Talent is assisting in hiring a Supervisor for Claims (CQI) in Irvine, California. The Supervisor will oversee the operations of the QA staff, ensuring compliance with Medi-Cal and Medicare guidelines in the Claims Department.

This role offers competitive compensation and a robust benefits package, along with opportunities for professional growth in a supportive working environment.