Senior Claims Integrity & Recovery Supervisor

L.A. Care; Los Angeles (CA); Vor Ort; USD 77.000 - 124.000; Vollzeit

Benefits dieser Stelle

PTO

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Zusammenfassung

L.A. Care Health Plan in Los Angeles, CA seeks a Supervisor, Claims Integrity & Recovery Services to lead a team responsible for identifying, preventing, and recovering improper claim payments across the organization.

You will oversee day-to-day review of pre- and post-payment claims, manage recovery activities, and ensure work is compliant with CMS and internal policies while driving quality and collaboration.

Qualifikationen

• Bachelor's Degree in Related Field or equivalent experience.
• 3+ years processing health plan claim recoveries in managed care.
• 1+ year in leading a process, program, or staff/supervisory role.

Aufgaben

• Oversee review of claim payments to detect overpayments and pricing discrepancies.
• Manage recovery activities: offsets, recoupments, refunds, and notices.
• Ensure compliance with CMS guidance and internal policies.

Kenntnisse

Prioritization

Multi-tasking

Data analysis

MS Office

Communication

Regulatory knowledge

Leadership

Ausbildung

Bachelor's degree

Tools

Facets

QNXT

HealthRules

EPIC Tapestry

Jobbeschreibung

L.A. Care Health Plan in Los Angeles, CA seeks a Supervisor, Claims Integrity & Recovery Services to lead a team responsible for identifying, preventing, and recovering improper claim payments across the organization.

You will oversee day-to-day review of pre- and post-payment claims, manage recovery activities, and ensure work is compliant with CMS and internal policies while driving quality and collaboration.