Supervisor, Claims - Long Beach
1 day ago
Job description
JOB DESCRIPTION Job SummaryLeads and supervises team responsible for claims activities including administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Also monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion and in accordance with cost-control standards.
Essential Job Duties
• Coordinates workflow and staffing of day-to-day claims activities and assigns and monitors work of staff in order to adhere to productivity and quality standards.
• Hires, onboards, trains, supervises, and develops claims team, and demonstrates accountability for team performance.
• Proactively plans for daily claims priorities, and responds to new priorities and process improvement opportunities assigned by leadership.
• Ensures execution of claim handling strategies including appropriate determination of coverage, processing guidelines and metrics.
• Reviews and analyzes claim reports to identify and address trends; recommends strategies to correct adverse trends.
• Effectively manages claims escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow-through to closure.
• Reviews and documents recommendations for claim disposition including evaluation, negotiation and settlement of claims in excess of staff authority levels.
• Compiles and submits daily, weekly and monthly departmental claims reports to leadership.
• In collaboration with senior claims leadership, develops claims department initiatives to improve overall efficiency.
• Completes claims projects as assigned.
Required Qualifications
• At least 5 years of medical claims processing experience, or equivalent combination of relevant education and experience.
• Thorough knowledge of processing outpatient and inpatient facility claims for Medicare, Medicaid, and Marketplace plans.
• Research, analysis, data entry, and auditing skills.
• Organizational skills and attention to detail.
• Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Ability to work cross-collaboratively in a highly matrixed environment.
• Strong customer service experience.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.
Preferred Qualifications
• Management/leadership experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Similar jobs
Los Angeles | Remote/In-Office (In-Office Preferred) |Auto Insurance Claims · Pay Range: $75,000- $98,000 Per Year. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire and will be dependent on a wide range of factors, in ...
1 day ago
We are looking for an experienced Supervisor to lead a team of claims advisors who provide in-person support to customers affected by wildfires. · This role focuses on guiding staff, ensuring compassionate service, · and maintaining efficient claims intake during a high-volume pe ...
1 month ago
Los Angeles | Remote/In-Office (In-Office Preferred) |Auto Insurance Claims · Pay Range: $75,000- $98,000 Per Year. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire and will be dependent on a wide range of factors, in ...
2 days ago
The Claims Supervisor works with the Claims Manager to oversee the daily operations of the claims department. · ...
1 month ago
The Claims Supervisor oversees the end-to-end claims process for Ardmore Home Design (AHD), a fast-paced and growing company in the luxury market. This role is responsible for developing a high-performing claims team, driving cross-functional collaboration, and ensuring claims ar ...
2 weeks ago
The Claims Supervisor oversees the end-to-end claims process for a fast-paced, high-volume company.This role is responsible for developing a high-performing claims team, driving cross-functional collaboration, and ensuring claims are resolved efficiently, accurately, and cost-eff ...
2 weeks ago
We are looking for an experienced Supervisor to lead a team of claims advisors who provide in-person support to customers affected by wildfires. · Oversee daily operations of in-person claims advisors at the support center · Ensure customers receive accurate, timely, and empathet ...
1 month ago
The Claims Supervisor oversees the end-to-end claims process for a fast-paced, high-volume company. This role is responsible for developing a high-performing claims team, driving cross-functional collaboration, and ensuring claims are resolved efficiently, accurately, and cost-ef ...
2 weeks ago
The Claims Supervisor works with the Claims Manager to oversee the daily operations of the claims department. · Ensure quality levels of performance are maintained throughout the Claims Department. · Maintain an up-to-date knowledge of national and state-wide standards and regula ...
1 month ago
The Claims Supervisor oversees the day-to-day operations of the Quality Analyst (QA) staff in the Continuous Quality Improvement (CQI) Unit of the Claims Department. This position is responsible for ensuring adherence to regulatory and internal guidelines in conjunction with comp ...
1 week ago
The Claims Supervisor oversees the end-to-end claims process for a fast-paced company. This role is responsible for developing a high-performing claims team and ensuring claims are resolved efficiently and accurately. ...
2 weeks ago
The Claims Supervisor oversees the end-to-end claims process for a fast-paced, high-volume company. · ...
2 weeks ago
· About the company · Ardmore Home Design (AHD), founded in 2008, is a privately owned, fast-paced, founder-led entrepreneurial company where we value people with strong skills to make our products and processes better every day. We design, sell, and distribute luxury home déco ...
2 days ago
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Claims Supervisor REMOTE. In this role you will oversee a team responsible for handling claims efficiently while ensuring adherence to quality standards and enhancing customer serv ...
1 month ago
We are seeking an experienced Workers' Compensation Claim Supervisor to lead a multi-account team in our Irvine office.This is a hybrid position that requires an in-office presence to effectively coach and mentor the team. · ...
2 days ago
We're seeking an experienced and motivated Workers' Compensation Claims Supervisor to join our team in Orange, CA. · Provide ongoing coaching, counseling, and feedback to team members to enhance skills and performanceFoster a collaborative and productive team environment focused ...
1 week ago
Lead a dynamic team in Glendale as Workers' Compensation Claims Supervisor and provide guidance, mentorship, and performance feedback to ensure exceptional claim handling. · ...
1 month ago
Overview · Position Title: Workers' Compensation Claim Supervisor · Location: Irvine, California · Schedule: Hybrid - 8am to 4:30pm CST · Salary Range: $110,000 - $118,000 · Build Your Career With Purpose at CCMSI · At CCMSI, we partner with global clients to solve their most com ...
1 day ago
This is a HYBRID position reporting to the Glendale office · 3 times a week We're seeking an experienced and motivated Workers' Compensation Claims Supervisor to join our team in Glendale, CA. · ...
1 month ago
Russell Tobin is seeking a dedicated and experienced Customer Service Supervisor for our utility's client, to lead a team of claims advisors providing in-person support to customers impacted by wildfires. This role is critical in ensuring compassionate, efficient, and accurate se ...
1 month ago