Claims Examiner Supervisor

This is a fully remote position, open to applicants in California.

📋 Description

• Oversee a team of claims staff.

• Manage claims inventory for various companies adhering to state and federal regulations utilizing inventory management systems and reports.

• Collaborate with other departments to address departmental and employee concerns.

• Review and revise policies and procedures.

• Supervise the work behaviors of subordinate staff.

• Coach, mentor, and reward team members based on individual performance.

• Conduct monthly and annual performance evaluations.

• Interview, recruit, and train new employees.

• Plan, assign, and oversee work tasks.

• Evaluate employee performance.

• Provide rewards and disciplinary actions as necessary.

• Address grievances and resolve issues.

• Supervise Claims Leads, Claims Examiners, Project Coordinators, and Adjusters.

• Assist Conifer Health’s healthcare clients in enhancing financial and clinical outcomes, while improving healthcare quality, cost, access, and patient satisfaction.

⛳️ Requirements

• High School Diploma or Equivalent required.

• Preferred 5-6 years of Supervisory/Management experience.

• Preferred 2-3 years of claims experience within a managed care setting.

• Familiarity with general office equipment.

• Solid understanding of health and managed care concepts and their relevance in claims adjudication.

• Strong knowledge of ICD.9.CM, CPT, HCPCS, RBRVS coding systems, and medical terminology.

• Must obtain and provide verification of all necessary vaccinations and screenings before commencing employment, as applicable and permitted by law.

• Ability to work seated, use a computer, and answer phone calls.

• Minimal travel capability required.

• Light physical exertion, including lifting up to 10 lbs.; regularly bending, stooping, and reaching to file.

🏝️ Benefits

• Management-level positions may qualify for sign-on and relocation bonuses.

• Comprehensive medical, dental, vision, disability, life, and business travel insurance.

• Paid time off (vacation and sick leave) with a minimum of 12 days per year.

• 401k plan with up to a 6% employer match.

• Ten paid holidays annually.

• Health savings accounts available.

• Flexible spending accounts for healthcare and dependents.

• Employee Assistance program offered.

• Employee discount program included.

• Optional pet insurance available.

• Legal insurance provided.

• Accident and critical illness insurance options.

• Long-term care insurance available.

• Services for elder and childcare support.

• Accidental Death & Dismemberment (AD&D) insurance provided.

• Auto and home insurance options available.

• For employees in Colorado, paid leave in line with Colorado’s Healthy Families and Workplaces Act.