Supervisor Claims

Providence; Anaheim (CA); On-site; USD 85,000 - 110,000; Full time

Job summary

Providence Medical Foundation in Anaheim, CA, seeks a seasoned leader to supervise the Claims Processing and UM Denial Letter Units under the Manager, Claims. The role focuses on guiding staff and ensuring efficient day-to-day operations within a busy claims environment.

You will be responsible for producing reports to ensure AB1455 compliance and adherence to CMS guidelines and department policies, while maintaining a high standard of service and operational excellence.

Qualifications

• 3 years experience in a leadership role within medical claims related field
• 5 years experience in medical/institutional claims examining within a medical group/IPA setting claim processing experience
• 2 years experience in a medical/institutional claims customer services unit within a health plan medical group or IPA setting

Responsibilities

• Supervise staff and oversee day-to-day operations of the Claims Processing and UM Denial Letter Units
• Provide reporting to ensure AB1455 compliance and CMS guidelines
• Uphold department policy and procedures

Skills

Leadership in medical claims

Staff supervision

Process optimization

Tools

Access

Teleform

IDX

Job description

Working under the direction of the Manager, Claims, this position has direct responsible for the supervision of staff and for overseeing the day-to-day operations of the Claims Processing and UM Denial Letter Units. Additional responsibilities include reporting functions to ensure compliance with AB1455, attention to CMS guidelines and department policy and procedures.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

• 3 years experience in a leadership role within medical claims related field
• 5 years experience in medical/institutional claims examining within a medical group/IPA setting claim processing experience
• 2 years experience in a medical/institutional claims customer services unit within a health plan medical group or IPA setting

Preferred Qualifications:

• Customer service experience within the Health Care Industry
• Access, Teleform and IDX experience

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.