Supervisor, Claims Processing - Medi-Cal
California, MO, United States
What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
The Supervisor, Claims Processing – Medi-Cal provides daily oversight of claims staff, business processes and inventory management. Ensures the claims team follows state/federal regulations and standard operating procedures. Develops best practices to optimize claim processing quality. Evaluates professional skills of team members and provide appropriate work assignments. Resolve claim payment issues and quality oversight. Assist in hiring and training new team members in their job responsibilities. Monitors individual and team performance to ensure quality and performance objectives are met. Assist in employee performance evaluation, coaching and professional development activities to improve performance efficiency.
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
CalPERS retirement
457(b) option with a contribution match
Generous paid time off- vacation, holidays, sick
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Paid life insurance for employees with additional options
Short-term, and long-term disability options
Pet care insurance
Flexible Spending Account – Health Care/Childcare
Wellness programs that promote a healthy work-life balance
Career advancement opportunities and professional development
Competitive salary with annual merit increase
Team bonus opportunities
Education & Experience
Four (4) years medical claims processing experience, at least two (2) years of experience in a supervisory capacity leading a team.
Three (3) years of experience in a managed care environment.
Experienced in benefit and financial matrix interpretation.
Experience preferably in an HMO or Managed Care setting.
High School diploma or GED required.
Bachelor's degree from an accredited institution preferred.
Key Qualifications
A thorough understanding of claims industry and customer service standards. Knowledge in CMS, DHMC and DHCS regulatory guidelines including AB1455. Extensive knowledge of ICD-9, ICD-10, CPT, and Revenue Codes.
Solid understanding of the DHCS, DMHC and CMS rules and regulations governing claims adjudication practices and procedures desired.
Principles and techniques of supervision and training.
Knowledge of medical terminology and understanding of healthcare claims.
Analytical skills with emphasis on time management, data base maintenance, spreadsheet manipulation, and problem solving.
Strong writing, organizational, project management, and communication skills proficiency required.
Excellent interpersonal/communication skills.
Must have a high degree of patience and ability to lead a large team of professionals.
Start your journey towards a thriving future with IEHP and apply TODAY !
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