Claims Supervisor

At MultiPlan, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all of our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and upward!!!

The Supervisor is responsible for managing the day-to-day planning and operations of the Team. This position is also responsible for serving as a resource for problem solving; staffing, service evaluation and enhancement; and policies/procedures and to ensure efficient operations in a fast-paced environment.

JOB SUMMARY: The Supervisor is responsible for managing the day-to-day planning and operations of the Team. This position is also responsible for serving as a resource for problem solving; staffing, service evaluation and enhancement; and policies/procedures and to ensure efficient operations in a fast-paced environment.

JOB ROLES AND RESPONSIBILITIES:

1. Manage daily operations and processes within the department by monitoring employee workflow and inventory, including distribution of claims/work, when applicable.
2. Train, mentor, motivate, support, and oversee staff performance; including coaching when needed.
3. Monitor compliance with all departmental policies, procedures, and workflows as well as interface with all other internal teams regarding procedural compliance.
4. Monitor departmental and individual performance metrics and take proactive action, when necessary, on a timely basis to maintain desired workflow outputs, acting upon variances when applicable.
5. Develop and implement workflow changes to improve service and production efficiency of the department; this may include collaboration with other teams.
6. Collaborate with the training team and all other internal teams to implement new and revised procedures, which may include suggested system changes or enhancements.
7. Manage and review complex and/or difficult claims or issues to determine best outcome.
8. Partner with internal and external contacts to achieve effective communications and maximum savings.
9. May act as a liaison in monitoring and supporting specific client, provider or departmental assignments through reporting and relationship building.
10. Oversight or research on special projects as assigned.
11. Select, develop, and evaluate staff to ensure the efficient operation of department.
12. Collaborate, coordinate, and communicate across disciplines and departments.
13. Ensure compliance with HIPAA regulations and requirements.
14. Demonstrate Company's Core Competencies and values held within.
15. Please note due to the exposure of PHI sensitive data - this role is considered to be a High Risk Role.
16. The position responsibilities outlined above are in no way to be construed as all encompassing.

Other duties, responsibilities, and qualifications may be required and/or assigned, as necessary.

JOB SCOPE: The individual impacts efficiency and effectiveness of team operations. This is a people management role that has the authority to initiate and communicate some HR actions (training, new processes, coaching, mentoring, etc.) but for others, such as hiring, salary adjustments, position change, termination, and other disciplinary actions, the individual collaborates on such issues with the next level. The individual must have the ability to exercise discretion and independent judgment to judiciously act in situations where specific guidelines may not apply.

Job Requirements:

JOB REQUIREMENTS (Education, Experience, and Training):
? Minimum high school diploma and three (3) years' related experience in healthcare or managed care industry; preferably with claims processing, auditing, and/or customer service.
? Minimum 2 years' experience in a leadership role
? State licensure certification, including NY Health and/or P&C State Adjustor license, may be required. If hired without certification, certification must be obtained, and maintained thereafter, within six months of notification. If the required state licensure certification(s) are not obtained or renewed within six months of notification, an employee may be moved to a position within a relevant job family that does not require certification/licensure, if and when such position is available. When an alternate position is unavailable, other employment actions may be implemented consistent with MultiPlan practice and policy.
? Knowledge of claims processing and procedure.
? Knowledge of provider billing and collection practices.
? Knowledge of medical coding systems and commonly used medical data resources preferred.
? Communication (written, verbal, listening) problem solving, organization, time management, leadership, and coaching skills.
? Knowledge of effective negotiations principles
? Ability to convey information clearly, effectively, and objectively.
? Ability to communicate and process detailed verbal and written instructions.
? Able to demonstrate teamwork, organization, prioritization, and time management.
? Ability to be detail oriented to ensure accuracy, including mathematical calculations.
? Ability to maintain commitment to providing a level of service within established standards.
? Ability to lead, motivate, manage, coach and mentor others.
? Ability to elicit trust and credibility with all levels of the organization.
? Ability to identify issues and determine appropriate course of action for resolution.
? Ability to adjust/alter workflow and schedule to meet deadlines in a fast-paced environment.
? Ability to analyze data and arrive at a logical conclusion.
? Ability to make decisions using limited or incomplete data, when necessary, situations arise.
? Ability to work independently and handle confidential information.
? Ability to manage multiple projects at the same time.
? Ability to use software and hardware related to job responsibilities, including MS Word and MS Excel spreadsheets and database software.
? Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier, and telephone.

As an Equal Opportunity Employer, the Company will provide equal consideration to all employees and job candidates without regard to sex, age, race, marital status, sexual orientation, religion, national origin, citizenship status, physical or mental disability, political affiliation, service in the Armed Forces of the United States, or any other characteristic protected by federal, state, or local law.
The salary for this position is $55k with a quarterly bonus potential. Specific offers take into account a candidate?s education, experience and skills, as well as the candidate?s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

Job Snapshot

Employee Type
Full-Time

Location
USA (Remote)

Job Type
Customer Service

Date Posted
03/03/2025

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