Our customer is a national insurance administration company who is growing very quickly in the Tampa Bay area. They are experiencing so much growth that they have added a new Claims Supervisor to their team. The Claims Supervisor is responsible for monitoring the daily activities within the department that processes the billing for patient healthcare services. This Supervisor ensures claims are either approved or denied, based on actual services rendered as well as compared to legislative requirement and plan agreements.

Duties and Responsibilities

• Effectively manage the performance of the Claims Team by providing daily leadership and support, coaching, feedback, and direction, incorporating positive feedback and reward mechanisms
• Monitor inventory levels and aging of claims and queues to assign work daily.
• Hire and manage staffing levels to ensure continuous, quality processing
• Conduct effective resource planning to maximize productivity and turn-around time
• Follow and maintain knowledge of Federal and State regulations as well as client requirements; implement changes regarding claims and billing standards
• Develop, revise, and monitor metrics to meet quality, time, service and productivity goals
• Provide expertise and general claims support to teams in reviewing, researching, investigating, negotiating, processing, and adjusting claims
• Identify and coordinate resources for re-work
• Analyze and identify trends and provide robust reports
• Conduct regular meetings with staff toward improving performance, quality and documentation
• Conduct training for new hires and ensure the ramp-up to required metrics is on track

Required Knowledge, Skills and Abilities

• Associate degree in a field related to managing claims in the healthcare field such as business administration, accounting, finance, or a related field or equivalent experience
• 3+ years of experience in a supervisory role in a healthcare claims processing setting where HIPPAA and HITECH standards are utilized, preferably in a healthcare
• Experience with benefit administration platforms such as Javelina preferred
• Knowledge of Federal and State codes related to fiscal operations of healthcare services
• Knowledge of medical terminology and Diagnosis Codes (ICD-9 & ICD-10)
• Ability to analyze and interpret problems in data collection, billing, and coding.
• Must be able to calculate and re-calculate claims, performing (sometimes complicated) calculations, applying formulas using multiplication and percentage

Salary: $60,000 to $80,000/year, with performance based quarterly bonus potential and full benefits package including 401(k)

Hours: 8-hour shift that begins between 6:30am & 8am Monday to Friday

Location: Tampa, FL - onsite only

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county , to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.