Supervisor Claims

Amerihealth
Published
July 18, 2021
Location
Jacksonville, FL
Category
Job Type

Description

Job Brief

Managed Care Claims Supervisor Opportunity. Work from home.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:
Oversee and manage claims handling process in order to meet client contracted response times.  Track production, error trending, develop workflow procedures and take corrective action on claim system issues.  Assist in backlog reduction, client contact on claim issues, client/provider education, and interdepartmental communication to expedite claim handling. Ability to give direction and training on extensive claim research, problem analysis and claim payments. Demonstrated ability to work independently, and establish and accomplish team goals. Investigative, decision-making, problem solving, interpersonal, and organizational skills required.
Education/Experience:
  • 1 to 3 years supervisory experience.
  • 1 year experience in HMO service setting preferred.
  • Bachelor’s Degree or equivalent education and experience required.
  • Ability to managed a Claims Examiner Team in a telecomutter environment.
  • Extensive knowledge of medical and/or hospital claims.
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