Job Information
TRIWEST HEALTHCARE ALLIANCE CORP Supervisor, Claims Admin - MSV Support in PHOENIX, Arizona
We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI and WY only).
Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.
Veterans, Reservists, Guardsmen and military family members are encouraged to apply!
Job Summary
The Supervisor, Claims Administration is responsible for the daily oversight of a claims administration functional team handling requests related to Government claims. This position may manage one or more work types including, but not limited to, claims research, reconsideration, correspondence, inquiries and escalations, and audits. This role is responsible for ensuring individual and team performance expectations are met within their assigned claims s). The Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes.
Education and Experience
Required:
High School diploma or GED U.S. Citizenship Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation. 4 years of healthcare claims, billing (or related healthcare area) experience 1 year in a Supervisory role or 2 years in a Team Lead (or equivalent) role Experience interpreting claims written policy and demonstrated understanding of automated transactions Demonstrated ability to communicate effectively, both verbally and in writing Preferred:
Associate degree or higher in related field Government claims experience Intermediate proficiency with MS Office suite, with an emphasis on Excel Knowledgeable of claims pricing methodologies Claims coding certification or equivalent experience
Key Responsibilities
Assists in the development and implementation of department policies and training. Audits completed work, performs analysis of results, and provides coaching for improvement. Responsible for the daily supervision of staff, including multiple job roles. Manages assigned functional team(s), to include people, workflows, performance, and procedures. Proactively identifies opportunities and collaborates with leaders and subcontractors to drive issue resolution. Coordinates with leadership, direct reports, and project teams regarding process changes. Collaborates cross-functionally with internal business partners on process changes and improvements. Makes recommendations to improve quality and efficiency to enhance service to internal and external stakeholders. Exhibits professionalism in all written and verbal communication. Hires, evaluates, and develops team members. Assesses team performance, initiates corrective action plans, and writes annual reviews. Provides telephonic customer service assistance to Government employees, providers, Veterans, and beneficiaries. Performs other duties as assigned. Regular and reliable attendance is required.