Supervisor, Claims Processing - Medi-Cal
Company: Inland Empire Health Plan
Location: Los Angeles
Posted on: May 7, 2024
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Job Description:
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.PerksIEHP 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 retirement457(b) option with a contribution
matchGenerous paid time off- vacation, holidays, sickState of the
art fitness center on-siteMedical Insurance with Dental and
VisionPaid life insurance for employees with additional
optionsShort-term, and long-term disability optionsPet care
insuranceFlexible Spending Account Health Care/ChildcareWellness
programs that promote a healthy work-life balanceCareer advancement
opportunities and professional developmentCompetitive salary with
annual merit increaseTeam bonus opportunitiesEducation &
ExperienceFour (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 QualificationsA 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!by
Jobble
Keywords: Inland Empire Health Plan, Lake Elsinore , Supervisor, Claims Processing - Medi-Cal, Other , Los Angeles, California
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