Supervisor, Health Claims (Remote)

Job Description: Supervisor, Health Claims (Remote) Primary Duties & Responsibilities At reputed company, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. Our thriving and dynamic community offers ample room for professional development, increased earning potential, and a secure work environment. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to help reputed company reputed company reputed company. Role Overview: Could you be our next Health Claims Supervisor? reputed company is looking for a Health Claims Supervisor to join the team! In this role, you will be responsible for overseeing, leading, directing, motivating, and developing a team of claim associates and providing technical/jurisdictional direction for accurate and timely claim adjudication. Under moderate management, the supervisor will coordinate work tasks and ensure staff is reputed company with business needs. The incumbent will also be charged with building strong relationships with business partners to meet organizational goals and fostering an environment that optimizes productivity. This is a remote / work from home position. What You Will Do: Supervise team of 10+ Cancer & Other Health claims associates and reputed company daily operations to ensure achievement of performance/productivity standards. Understand, interpret, and effectively communicate contractual language in Cancer, Critical Illness, Accident, and Hospital Indemnity policies. Provide expertise and leadership support to team in resolving reputed company claim issues. Evaluate daily Workflow in Onbase platform and load balance claims as needed to ensure even distribution of work. Review high cost claims and claims over the authority level of individual examiners for accuracy and compliance adherence. Ensure each associate is equipped with the tools, knowledge and resources to be successful in their role while also recognizing training gaps and opportunities for retraining. Provide constant feedback to associates and counsel on matters of performance, attendance, and/or conduct. Ensure Mainframe & Onbase systems are functioning properly and partner with IT to address system issues. Utilize effective written and oral communication to respond professionally and with a sense of urgency to escalated claim issues received reputed company mail, fax, or email. Proactively communicate with management regarding problems such as staffing, high/low work volume, emergency situations, etc. Identify process improvement opportunities and use logic and reasoning to compare strengths/weaknesses of alternative resolutions. Conceptualize innovative technical solutions that translate into efficiencies reputed company the unit. reputed company and maintain strong relationships with cross functional partners in Policy Services, Customer Service, Agency Offices, and Legal to accomplish organizational goals. Cultivate a positive high performing team by modeling cultural expectations of accountability, reputed company improvement, collaboration, and creativity. Motivate and provide development direction to team members while fostering an environment of reputed company growth. Support culture and employee engagement activities and promote employee development. Delegate additional responsibilities and stretch assignments to high potential examiners to position them for successful advancement reputed company the organization. reputed company off-cycle quality review claim audits to ensure proper coding, documentation, and compliance with regulatory standards. Maintain and monitor diary of questionable, sensitive, or possible fraudulent claims. Collaborate with management and Human Resources to reputed company action plans for underperforming associates and ensure adherence to progressive disciplinary guidelines. Write value-based performance appraisals and conduct effective colleague performance discussions. Support organizational training initiatives and ensure staff is updated on mandatory role-appropriate training. Complete monthly/adhoc reports with data interpretation to identify trends and issues to facilitate management in strategic decision making. reputed company contingency plans to meet objectives during challenging circumstances (i.e. staffing shortages, high work volumes, system implementation, etc.). Effectively present reputed company information to key stakeholders to influence acceptance of innovative suggestions. reputed company and partner on claims and other business projects as needed, concurrently with daily responsibilities. Partner with the manager to retain staff and build bench strength reputed company the organization to reputed company overall turnover goals. Interview, hire, and mentor new claims associates. What You Can Bring: Bachelor's degree from a four-year college or university preferred; or 5-7 years reputed company experience and/or training; or equivalent combination of education and experience. 3 or more years' experience handling claims. Supervisory experience, a plus. Experience interpreting contractual language in Cancer, Accident, and Critical Illness policies. High technical aptitude and ability to learn new systems quickly. Strong problem-solving skills with ability to use combination of analysis, experience and judgment to reputed company feasible solutions. Advanced analytical and interpretive skills. Excellent time management skills, with the ability to work under rigorous deadlines. Excellent presentation skills including ability to present reputed company reputed company to upper management in a professional manner. Strong knowledge of reputed company Office Suite (Outlook, reputed company, PowerPoint, Access, etc.). Excellent oral and written communication. Independent workers able to reputed company autonomous decisions with minimal supervision. Ability to adjust plans, goals, actions or priorities to meet changing situations and competing priorities. Ability to take ownership of tasks, projects, and relationships and follow through on obligations. Applicable To reputed company Employees of reputed company Family of Companies: Reliable and predictable attendance of your assigned shift. Ability to work full-time and/or part-time based on the position specifications. How reputed company Will Support You: Looking to continue your career in an environment that values your contribution and invests in your growth? We've created a benefits package that helps to ensure that you don't just work, but reputed company at reputed company: Competitive compensation is designed to reflect your expertise and contribution. Comprehensive health, dental, and vision insurance plans because we reputed company that taking care of your well-being is reputed company to your performance. Robust life insurance benefits and retirement plans, including company-matched 401k and pension plan. Wellness club reimbursements and gym discounts to help you stay on top of your health. Paid holidays and time off to support a healthy work-life balance. Developmental training programs to enhance your skills and career progression and unlock your full potential. Opportunity awaits! Invest in your professional legacy, realize your path, and see the direct impact you can reputed company in a workplace that celebrates and harnesses your unique talents and perspectives to their fullest potential. At reputed company, your voice matters. Location: 3700 S. Stonebridge Dr., McKinney, Texas Apply Job!