Claims Supervisor

Community First Health Plans; San Antonio (TX); On-site; USD 55,000 - 75,000; Full time

Job summary

A healthcare services organization in San Antonio is seeking a Claims Processing Supervisor. The role involves supervising a claims processing unit and addressing escalated issues while ensuring compliance with policies. Candidates should have a high school diploma and five years of claims experience, with preferred supervisory experience in Medicaid, Medicare, or commercial claims. Proficiency in Microsoft Office is also required. The position provides an opportunity to improve work procedures and support staff development.

Qualifications

• Five years claims experience required.
• Medicaid, Medicare, and Commercial claims experience are required.
• One to two years supervisory experience preferred.

Responsibilities

• Supervises and directs the activities of the claims processing unit.
• Responds to issues escalated from claim examiners.
• Plans and implements methods to improve work procedures.

Skills

Claims processing

Supervisory experience

Project coordination

Proficiency in Word, Excel, PowerPoint

Education

High school diploma

Job description

POSITION SUMMARY/RESPONSIBILITIES

Supervises, assists, and directs the activities of the assigned claims processing unit and the assigned staff. Responds to issues escalated through the claim examiners. Provides solutions to problems in accordance with CFHP policies and procedures. Plans and implements methods to improve work procedures and areas.

EDUCATION/EXPERIENCE

High school diploma required. Five (5) years claims experience is required. One to two (1-2) years supervisory experience preferred. Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years’ experience project coordination in a managed care environment is preferred. Proficiency in Word, Excel, and Powerpoint, is required.