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Claims Processing Supervisor
Ref No.: 18-45681
Location: Oakland, California
Start Date / End Date: 09/04/2018 to 08/30/2019
Job Title: Claims Processing Supervisor
Location: Oakland, CA, 94612
Job Reference Code: 18-45681
 
Description:
Responsible for the operations of one or more claims processing units, including timely and proper adjudication of claims in accordance with contractual benefits. Responsible for providing leadership and direction to employees. Directs the processing of insurance claims to meet operation, financial, and service requirements. Develops and executes strategic and operational business plans for the departments. Coordinates department operations and modifications with other areas of the organization.
 
Essential Functions:
• Works on issues of broad scope.
• Receives assignments as objectives with the processes necessary to fulfill those goals.
• Requires considerable planning and direction setting.
• Develops and directs work schedules and monitors work flow to achieve established goals and objectives.
• Responsible for recommending changes in guidelines, procedures, and policies.
 
Basic Qualifications:
• Minimum three (3) years of experience in claims processing.
• Experience in LMP environment managing large groups of employees in a collaborative work team environment required
 
Education
• Bachelor's degree in business administration, OR four (4) years of experience in a directly related field.
• High School Diploma or General Education Development (GED) required.
 
Additional Requirements:
• Requires knowledge of claims processing and working knowledge of another functional area.
• Must be able to work in a Labor/Management Partnership environment.
 
Preferred Qualifications:
• Minimum three (3) years of management in a claims processing environment preferred.
• Five (5) years of management experience.
• Master's degree preferred
 
Manager’s Comments:
If candidates do not have a degree, they must have an additional 4 years’ experience plus the additional 3 years required for the role which totals 7 years. Looking for someone who has experience with supervising Staff. ( This person would be supervising approximately 12 people) must have managed/supervised others in order to be considered. Their main role is to manage the claims processing staff. Experience with Pivot tables (needs to be expert in Excel), Proficient in MS Office - Word, Excel, Outlook, schedule Skype meetings, will be sorting work and divide amongst the team Ideal candidate would have Labor Management experience and claims knowledge ( Epic would be great).