• Claims Supervisor

    Job Locations US-NC-Gastonia
    Posted Date 1 month ago(9/11/2018 6:01 PM)
    Job ID
    # of Openings
  • Overview

    Excellent Benefits Package!!!

    Projected Hiring Range:  Depending on Experience


    Closing Date: Open Until Filled


    Primary Purpose of Position: This position performs difficult and technical work related to claims adjudication and is responsible for operationalizing the work of the Claims department. Provides oversight and supervision of the Claims Analysts.





    Role and Responsibilities:

    40%: Overall Responsibilities

    • Provides comprehensive support to department by being detail-oriented and resourceful in ensuring completion of projects as assigned
    • Multi-tasks effectively to complete tasks in a timely manner
    • Provide leadership for the claims functions
    • Provide assistance to Claims Manager as needed


    40%: Monitors Claims Processing System


    • Monitors claims adjudication workflow daily
    • Performs review of claims adjudication to determine areas improvement is needed
    • Assigns projects based on the results of claims adjudications to Claims Analysts


    20%: Supervision of Claims Analysts


    • Monitors the work of employee supervised through regular observation/review of job performance and provides needed direction/guidance, including timely supervisory counseling and/or disciplinary action when needed
    • Objectively and thoroughly completes all employee performance reviews (probationary and annual) by due date




    Knowledge, Skills and Abilities:

    • Knowledge of medical claims processing and provider reimbursement
    • Knowledge of automated claims processing systems
    • Knowledge of the principles and practices of public and business administration and office procedures, practices, and equipment
    • General knowledge of personnel policies and procedures
    • Excellent computer skills including proficiency in Microsoft office products
    • Analytical problem solving, verbal and quantitative skills
    • Ability to initiate and assign projects to evaluate their effectiveness
    • Ability to exercise judgment and discretion in establishing, applying, and interpreting policies and procedures
    • Ability to plan, assign, and supervise the work of subordinate employees
    • Ability to establish and maintain effective working relationships with agency personnel, providers and the general public




    Education/Experience Required:

    Associates Degree in Accounting, Business, Public or Hospital Administration and three (3) years of experience in medical claims processing or an equivalent combination of education and experience. Must have two (2) years of demonstrated supervisory experience or departmental coordination responsibilities (which must be evidenced in the description of job duties). Experience may be substituted for education on a case-by-case basis and only during exceptional circumstances.


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