Claims Production Supervisor

HealthPartners; BLOOMINGTON (MN); On-site; USD 95,000 - 135,000; Full time

Job summary

HealthPartners in Bloomington, MN is seeking a Claims Department Manager to oversee adjudication of claims, inquiries, and staff performance. You will guide team growth, ensure policy compliance, and drive efficient claim processing in a dynamic healthcare environment.

The role emphasizes leadership, training, and collaboration with internal and external stakeholders to achieve department objectives and high levels of service.

Qualifications

• Bachelor’s Degree in management, business, health care, or related field.
• Associate Degree with at least 2 years of leadership/management experience; waivable with 4 years.
• Experience interacting with all levels of HealthPartners staff and external customers.
• Ability to lead through change and adapt quickly.
• Strong analytical and accounting awareness.

Responsibilities

• Supervise staff, including hiring, transfers, promotions, discipline and performance reviews.
• Train permanent and temporary staff in the Claims Department.
• Promote teamwork and high morale.
• Create high-performance teams using metrics and goal setting.
• Set department goals and monitor outcomes.
• Motivate staff to meet quality and production targets.
• Identify performance issues and implement corrective actions.
• Coordinate with Technical Support to determine audit levels.

Skills

Leadership

Staff development

Communication

Problem solving

Interpersonal skills

Change management

Time management

Education

Bachelor’s Degree in management

Associate Degree + 2 years leadership

Job description

POSITION PURPOSE:

• Demonstrate a commitment to the Corporate and Department mission and vision.
• Manage and monitor the expedient and accurate adjudication of claims and adjustments and/or refunds.
• Organize and oversee the overall resolution of written and verbal inquiries from internal and external members.
• Provide the guidance, motivation, and support necessary to enable individual growth and team work in line with the individual needs, department objectives, and marketplace expectations.

ACCOUNTABILITIES:

• Responsible for the supervision of staff, including having the authority to hire, transfer, lay off, promote, discipline and discharge, train, reward and review performance of employees. Ensures compliance to organizational and departmental policies and procedures.
• Ensure, direct, and/or provide the training of staff, both permanent and temporary to the Claims Department
• Promote teamwork and encourage high levels of morale and motivation.
• Create high performance work teams through the use of performance measurements, individual goal setting, and monitoring and evaluation of results.
• Work with staff to develop and implement goals and objectives both individual and for the department.
• Motivate staff to meet/exceed department quality and production expectations
• Identify staff performance issues and prepare and implement action plans to resolve problems
• Work with Technical Support Coordinators to determine level of claims requiring auditing for each examiner.

REQUIRED QUALIFICATIONS:

• Bachelor’s Degree in management, business, health care, human relations, or related area, or Associate Degree with at least 2 years of leadership/management experience. Education may be waived with a minimum of 4 years of leadership/management experience.
• Detailed understanding of the health care industry, including internal operations of insurers and provider network arrangements.
• Ability to interact with all levels of HealthPartners staff and external customers
• Must be able to establish and maintain effective, courteous and confidential relationships with staff, providers, and members.
• Strong interpersonal and human relations skills.
• Work independently and as a team member.
• Ability to lead others through change and to be flexible and adaptive to changes; ability to make immediate adjustments to work direction.
• Provide an environment that fosters enthusiasm; pride in the job, and commitment to the goals and visions of HealthPartners.
• Establish a working environment free from harassment and discrimination.
• Demonstrate effectiveness in evaluation employees and giving feedback.
• Ability to identify training needs and provide learning opportunities.
• Ability to make verbal presentation and lead discussions
• Advanced analytical skills and problem solving ability.
• Experience in interpretation and implementation of technical data and contracts.
• Proven logical and principle-based decision making, and ability to meet deadlines.
• Strong organizational and time management skills.
• Working knowledge of CQI process and principles.
• Computer knowledge.
• General knowledge of accounting principles

PREFERRED QUALIFICATIONS:

• Bachelor’s Degree in management, business, health care, human relations, or related area, or Associate Degree with at least 4 years of supervisory experience in a health care setting.
• 2-4 years HealthPartners claims experience and familiarity with the goals and objectives of HealthPartners.
• Experience processing claims and a general knowledge of various processing systems.
• Working knowledge of Collective Bargaining Agreements.
• Project management experience.

DECISION-MAKING:

Must have the ability to work and make logical decisions independently in a fast-paced continuously changing environment. Has latitude in the allocation of work team to meet customer service objectives. Decisions, which affect the entire department, should be communicated with appropriate team members.