Claims Examiner Supervisor

Conifer Health Solutions; Frisco (TX); On-site; USD 47,000 - 70,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401k with employer match

Paid time off

Job summary

Conifer Health Solutions in Frisco, TX is seeking a supervisor to lead a team of claims personnel and optimize claims operations across multiple companies. You will oversee inventory management, ensure adherence to state and federal guidelines, and partner with other departments to resolve issues.

The role requires strong knowledge of health and managed care concepts, with experience in supervising staff and delivering performance reviews.

Qualifications

• High School Diploma or Equivalent.
• 2-3 years claims experience in a managed care environment preferred.
• 5-6 years Supervisory/Management experience preferred.
• Must have an excellent understanding of health and managed care concepts and their application in the adjudication of claims.

Responsibilities

• 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.

Skills

Supervisory experience

Claims knowledge

Team leadership

Education

High School Diploma or Equivalent

Job description

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.

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.

Supervisory Responsibilities

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

Knowledge, Skills, Abilities

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.

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

Education / Experience

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

PHYSICAL DEMANDS

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.

WORK ENVIRONMENT

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

Other

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 from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Compensation

Compensation and Benefit Information

• Pay: $46,924.80 - $70,408.00 annually. Compensation depends on location, qualifications, and experience.
• Management level positions may be eligible for sign-on and relocation bonuses.

Benefits

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, life, and business travel insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.