Claims Examiner Supervisor

Eodr; United States; Remote; USD 47,000 - 70,000; Full time

Benefits offered by this job

Medical insurance

401k with employer match

Paid time off

Job summary

Conifer Health, part of the Tenet family, is seeking a supervisor for its claims team in the United States. The role involves supervising staff, managing claims inventory across multiple client companies, and coordinating with other departments to resolve complex issues.

It also includes reviewing policies and conducting regular performance evaluations. Applicants should have a high school diploma, 5–6 years of supervisory experience, and 2–3 years in managed care claims, with strong knowledge

Qualifications

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

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.
• Deliver monthly/annual performance reviews and coach staff.

Skills

General office equipment experience

Health care concepts & adjudication

ICD.9.CM, CPT, HCPCS, RBRVS knowledge

Education

High School Diploma or Equivalent

5-6 years Supervisory/Management experience

2-3 years claims experience in managed care

Job description

JOB SUMMARY

Include the following. Others may be assigned.

1. Supervise a team of claims personnel.
2. Manage claims inventory for multiple companies according to state and federal guidelines utilizing inventory management systems and reports.
3. Team with other departments to resolve departmental/employee issues.
4. Review and update policies and procedures.
5. 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

Include minimum education, technical training, and/or experience preferred to perform the job.

• 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 and Benefit Information

Compensation

• 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.