Supervisor Claims

Providence; Mission Hills (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Providence Medical Foundation seeks an experienced supervisor to lead the Claims Processing and UM Denial Letter Units. Reporting to the Manager, Claims, you will oversee day-to-day operations, ensure accuracy, and support staff development.

Key responsibilities include maintaining compliance with AB1455, CMS guidelines, and department policies, plus generating reports to monitor performance. Collaboration with health-plan teams and providers is essential.

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
• Prepare and submit reports to ensure compliance with AB1455 and CMS guidelines
• Adhere to department policy and procedures while maintaining quality and service levels

Skills

Leadership

Claims processing

Staff supervision

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?

Ourbest-in-class benefitsare 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 ourMission of caring for everyone, especially the most vulnerable in our communities.