WC Medical Claims Specialist Supervisor - 20068255

Ohio; Columbus (OH); On-site; USD 45,000 - 75,000; Full time

Job summary

An established industry player seeks a dedicated professional to manage Medicare Subrogation and enhance billing processes. This role involves overseeing team performance, producing essential management reports, and ensuring compliance with regulations. The ideal candidate will possess a strong background in business administration or insurance claims, along with supervisory experience. Join a dynamic environment that values flexibility and operational excellence, where your contributions will directly impact the efficiency of critical processes. If you are ready to take on a challenging yet rewarding position, this opportunity is perfect for you.

Qualifications

• Completion of core coursework in business administration or related field.
• 24 months of experience in insurance claims or supervisory roles.

Responsibilities

• Manage Medicare Subrogation and oversee billing procedures.
• Produce reports on business activities and staff performance.
• Coordinate resolution of complex billing issues.

Skills

Medicare Subrogation

Data Analysis

Billing Compliance

Training Development

Education

Undergraduate Program in Business Administration

Experience in Insurance Claims

Job description

BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC’s seven offices across the state. BWC offers flextime work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.

1. Direct responsibility over team processing Medicare Subrogation (medical bill subrogation/disputes)
2. Produce & maintain data for weekly/monthly management reports of statistics surrounding business activities and monitoring of staff performance
3. Monitor existing billing procedures and oversee implementation of new/revised billing processes to ensure compliance with applicable laws, rules & regulations.
4. Coordinate resolution of complex billing issues as they relate to medical billing payment and subrogation.
5. Identify training opportunities and assist in development of training material

To Qualify, You Must Clearly Demonstrate:

Required Experience and/or Education:

Completion of undergraduate program core coursework in business administration or related field of study.

Or 24 months of experience in a private insurance organization as claims representative, nurse, or rehabilitation specialist; 6 months of experience providing work direction to claims processing staff.

Or 24 months of experience managing medical-only &/or lost-time claims, serving as the primary decision maker, including making initial determinations of claims, with overall responsibility & accountability for claims & management of claims to desired outcomes.

Or 24 months of supervisory experience within the Ohio Bureau Of Workers' Compensation, with at least 12 months involving telephoned, in-person, &/or written contact with providers, claimants, employees, public officials, attorneys, & the general public to provide information & answer inquiries concerning various operations, services, & policies & procedures of the agency.

Or an equivalent combination of experience and education meeting the Minimum Class Qualifications For Employment noted above.