Healthcare Claims Operations Supervisor

🕒 il y a 3 jours

🐊 Florida – Distant

🐊 Florida – Remote

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

⚙️ Opérations

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Imagenet LLC

Site WebLinkedInTous les Emplois

1001 - 5000 employés

🏥 Santé

📦 Logistique

📣 Marketing

💰 Private Equity Round en 2022-12

Healthcare • Logistics • Marketing

Imagenet LLC est un fournisseur de premier plan de services de continuité d'activité pour les organisations de santé, spécialisé dans les solutions de salle de courrier numérique, l'arbitrage des réclamations, les opérations de centre de contact et la gestion des flux de travail. Avec plus de deux décennies d'expérience et une réputation d'amélioration de l'efficacité et de la précision, Imagenet s'associe aux plans de santé pour rationaliser les processus et améliorer la satisfaction des membres. Leurs services sont conçus pour réduire les délais de traitement des réclamations, augmenter les capacités de traitement et réduire les temps d'attente des centres de contact. En intégrant des solutions évolutives adaptées aux besoins spécifiques, Imagenet permet aux organisations de santé d'accélérer la productivité et de réduire les défis opérationnels.

Description

• Oversee daily claims operations across assigned accounts and lines of business • Ensure achievement of client KPIs, SLAs, quality standards, and operational deliverables • Monitor productivity, inventory, aging, turnaround times, workflow distribution, attendance, and backlog risks • Develop and execute action plans to address performance gaps and operational challenges • Partner with Workforce Management and Operations Leadership on staffing, forecasting, and capacity planning • Support implementations, transitions, and account expansions • Maintain ownership of account-level operational metrics and performance outcomes • Analyze operational trends and recommend actionable solutions • Hold Team Leads and staff accountable through coaching, performance reviews, corrective actions, and performance improvement plans • Serve as a primary operational contact for assigned client accounts • Participate in business reviews, client meetings, calibrations, and operational discussions • Manage client concerns and escalations through timely resolution • Prepare, analyze, and present operational reports, dashboards, and performance metrics • Deliver accurate and timely reporting to clients and internal leadership • Ensure compliance with client requirements, HIPAA regulations, CMS guidelines, and company policies • Partner with Quality Assurance on calibrations, audits, error trend analysis, and remediation • Conduct root cause analysis and implement corrective actions • Coach, mentor, and develop Team Leads and Claims Examiners • Support onboarding, nesting, cross-training, and ongoing employee development • Promote engagement, retention, succession planning, and professional growth

🎯 Exigences

• Minimum 3–5 years of healthcare claims leadership experience • Prior supervisory experience overseeing production teams required • Strong experience managing healthcare payer operations and claims workflows • Experience with client-facing operations and client relationship management • Strong reporting and data analysis experience required • Experience owning operational KPIs and performance deliverables • Strong leadership, accountability, organizational, and communication skills • Intermediate to advanced Excel and reporting/dashboard experience required • Experience with systems such as EZ-CAP, QNXT, Facets, Jiva, Plexis, or similar preferred • Experience managing offshore and/or remote teams preferred • Successful completion of training and demonstrated proficiency in assigned claims processes • Knowledge of HIPAA regulations, CMS guidelines, and company policies

🏖️ Avantages

• Remote work offered • Equipment provided • Paid training to set you up for success • Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k) • Paid Time Off (PTO) • 7 paid holidays • A supportive team and a company that values internal growth