Supervisor, Claims

University of Pittsburgh Medical Center Pittsburgh, PA
Job Description

Job Title: Supervisor, Claims

Job ID: 696635

Status: Full-Time

Regular/Temporary: Regular

Hours:

Shift: Day Job

Facility: UPMC Health Plan

Department: TPA Claims_Ops

Location: 600 Grant St, Pittsburgh PA 15219

Description

Are you a leader in the health insurance field who is looking to join a growing and dynamic team? If so, an opportunity as UPMC Health Plan's Supervisor, Claims may be the perfect fit for you. This position requires management level experience in planning, directing, and responsible for training personnel. This person will prepare and give evaluations to employees and maintain excellent working relationships with all departments. They will be responsible for team performance, including accurate and timely completion of assigned claim inventories. They will also ensure effective employee development and training. The Supervisor must use their knowledge and understanding of claim inventory trends and other information generated to identify opportunities to improve claim performance.

Responsibilities:

* Enhance communication via effective team meetings, huddles, and employee one on ones

* Ensure team performance meets or exceeds claim timeliness and quality standards for regulatory compliance and performance guarantees

* Identify trends and partner with Support team and Management to make recommendation and improve operational performance

* Maintain a positive work environment through employee recognition and interaction

* Manage special projects

* Meet deadlines and turnaround times set by management (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both)

* Participate in interviewing, hiring, and training of team members

* Strategize, plan, organize, and execute efficient inventory management

* Supervise and monitor ongoing performance of team members. Continually examine team performance against department standards. This includes timely employee feedback via employee scorecards

* Work in conjunction with other Supervisors to allocate and adjust team resources as daily needs required

Qualifications

* Bachelors degree in business, health care or management related field or equivalent experience;

* Minimum 3 years of health insurance experience preferred;

* Minimum 3 years leadership experience (leading, mentoring, coaching, or teaching);

* Excellent planning, communication, documentation, organization, analytical and problem solving abilities; Medical Terminology or medical billing experience;

* High level of professionalism, enthusiasm, and initiative on a daily basis.

* Working knowledge of Commercial, Medicaid and Medicare plans.

* Working knowledge regarding Coordination of Benefits.

* Ability to maintain quality and production designated standards established for handling work, problem solve effectively and organize workflow.

* Ability to handle multiple priorities in a fast-paced production environment;

* Some travel may be required. Must be able to serve as a positive extension of the management team.

Licensure, Certifications, and Clearances:

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $22.60 to $39.11

Union Position: No

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