Claims Supervisor Job at Robert Half (Las Vegas)

Customer Service Supervisor

We are seeking a dedicated Customer Service Supervisor to join our team in Winst...

Location

United States , Winston-Salem

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 3 years of experience in a customer service role
Proven experience in answering inbound calls effectively and professionally
Proficient in handling healthcare claims
Knowledge of claim adjudication processes and procedures
Experience using CRM (Customer Relationship Manager) software
Excellent customer service skills, with the ability to resolve issues promptly and effectively
Ability to supervise and lead a team, ensuring high-quality customer service at all times

Job Responsibility

Overseeing the customer service team and enhancing service procedures to improve customer satisfaction
Handling complex customer service issues and ensuring timely resolution
Monitoring and analyzing customer service performance metrics to drive improvements
Coordinating with the team to handle healthcare claims-related inquiries from customers
Utilizing CRM tools to maintain and update customer records and track interactions
Implementing strategies to improve quality of service, productivity and profitability
Collaborating with team members to understand their challenges and identify improvements
Providing guidance and support to the team, fostering a supportive and cohesive work environment
Ensuring adherence to company policies and regulations related to customer service
Leading and motivating the team to meet and exceed their performance goals

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Medicare Audit & Appeals Supervisor

Supervise employees in the Revenue Cycle Management function while acting as a r...

Location

United States , Saint Paul

Salary:

5666.67 - 7791.67 USD / Month ▼

Baxter

Expiration Date

Until further notice

Requirements

Respiratory Therapist (RT), Licensed Practical Nurse (LPN), or Registered Nurse (RN) or Paralegal required
Current professional licensure or certification as required by the state of residence
3+ years’ experience in Medicare Audits, Medical Claims, Appeals or Third-Party Reimbursement
1+ years leadership or supervisory experience
Strong critical thinking and problem-solving skills
Knowledge of the various contractors Medicare Fee for Service audits, preferred
Knowledge of Medicare Regulations preferred
Experience with Third Party Compliance preferred
Experience with Durable Medical Equipment provider preferred
Six Sigma Green Belt preferred

Job Responsibility

Directly supervise assigned staff, including on-going performance feedback
Apply corrective measures as appropriate to ensure standards are maintained and goals are achieved
Provide work direction and content expertise to direct reports
Supervise medical reimbursement including Clinical Review for coverage and Medicare Appeals
Prepare and submit pre- and post-payment Audits to Medicare programs
Evaluate and process daily adjustment requests as needed
Assist staff in career development and training
Provide training and mentorship to new team members
Monitor workloads, including daily performance metrics, overdue activities and pending files
Identify and resolve issues on complex patient files

What we offer

Medical and dental coverage starting on day one
Basic life insurance
Accident insurance
Short-term and long-term disability insurance
Business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan with company matching
Flexible Spending Accounts
Educational assistance programs
Paid holidays

Fulltime

Credit Hire Supervisor

This is a brilliant opportunity for someone with supervisory or management exper...

Location

United Kingdom , Liverpool

Salary:

35000.00 - 45000.00 GBP / Year

Douglas Scott

Expiration Date

Until further notice

Requirements

Solid supervisory or management experience in credit hire, claims, or legal services
Strong understanding of motor claims, litigation, and credit hire processes
Great leadership and coaching skills
Confidence managing client relationships and resolving issues
The ability to juggle a busy caseload and meet deadlines

Job Responsibility

Managing a team of credit hire handlers
Overseeing complex and high-value cases
Ensuring performance, compliance, and service standards are met
Mentoring and supporting your team
Building strong client relationships
Identifying opportunities for continuous improvement

What we offer

A flexible and comprehensive benefits package
Personal development and wellbeing resources

Fulltime

Service Supervisor

SISCO, a Cottingham & Butler company, is a leading third-party benefit administr...

Location

United States , Dubuque, Iowa

Salary:

Not provided

Cottingham & Butler

Expiration Date

Until further notice

Requirements

Medical claims and customer service supervisor experience preferred

Job Responsibility

Ensure direct reports meet performance and accuracy goals
Lead, coach, and develop team members through training, feedback, and recognition
Oversee hiring, supervision, and retention of service staff
conduct performance reviews and support professional growth
Share daily/weekly feedback with Quality Assurance and Operations to identify trends and training needs
Maintain turnaround times and call standards that meet or exceed client and SISCO expectations
Manage daily workflow and projects related to PPO and Provider Maintenance

Claims Examiner Senior

The Claims Examiner Senior is responsible for reviewing, analyzing, researching,...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

Associate's degree or equivalent job-related experience required
Minimum of 3 years’ experience processing medical claims in the healthcare industry
Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies
Must have excellent written, verbal, organizational and interpersonal communication skills
Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills

Job Responsibility

Analyze medical claim information and take appropriate action for payment resolution in accordance with policies and procedures, desktops, processing guidelines, and federal regulations
Process medical claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms from facilities, physicians, Home Health, Durable Medical Equipment providers, laboratories, etc
Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes
Process provider refunds, reconsiderations, and direct member reimbursements
Process medical claim adjustments, recovery of claim overpayments, and execution of claim batch adjudication
Solve moderately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager
Assist with database improvements and testing for system upgrades, conversions, or implementation of new processes
Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management
Sets high standards of performance and promotes teamwork to achieve established team goals, while maintaining a positive, professional attitude
Contacting/responding to internal and external customers for resolution on claim issues

Fulltime