Remote Claims Operations Supervisor

Alliance Health; Morrisville (NC); Hybrid; USD 70,000 - 89,000; Full time

Benefits offered by this job

Medical, Dental, Vision, Life, LTD

Generous retirement savings plan

Hybrid/remote work options

Paid time off including vacation, sick

Dress flexibility

Job summary

Alliance Health in Morrisville, NC seeks a Claims Supervisor to oversee data entry, payments, credits, and adjustments while guiding a team of Claims Research Analysts. You will train staff, conduct audits, and drive process improvements to meet performance metrics.

The role offers a primarily remote schedule with intermittent onsite training and team meetings, along with a comprehensive benefits package and cross-team collaboration opportunities.

Qualifications

• Bachelor's degree from an accredited college or university in Business Administration or related field and three (3) years of experience in claims leadership experience with focus in leading projects and people.
• Preferred: Experience in Behavioral Healthcare agency and knowledge of CPT codes, Medicaid, and IPRS preferred.
• Knowledge of Medicaid and IPRS rules

Responsibilities

• Oversee claims data entry, payments, credits, and adjustments.
• Train and develop Claims Research Analyst team members.
• Audit claims for performance and maintain productivity standards.
• Monitor operations and implement new procedures as directed.
• Ensure claims are paid promptly according to guidelines.
• Collaborate with provider networks and internal teams to resolve issues.
• Maintain and analyze daily, weekly, and monthly reports to track processes.

Skills

Problem solving

Delegation

Communication skills

Staff development

Data analysis

Decision making

Reporting

Budgeting knowledge

Customer service

Medicaid knowledge

Education

Bachelor's degree in Business Administration or related field

Job description

Alliance Health in Morrisville, NC seeks a Claims Supervisor to oversee data entry, payments, credits, and adjustments while guiding a team of Claims Research Analysts. You will train staff, conduct audits, and drive process improvements to meet performance metrics.

The role offers a primarily remote schedule with intermittent onsite training and team meetings, along with a comprehensive benefits package and cross-team collaboration opportunities.