Supervisor Claims Processing - Tampa FL

Profile

Description

The Supervisor, Claims Processing reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. The Supervisor, Claims Processing works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach.

Responsibilities

The Supervisor, Claims Processing determines whether to return, deny, or pay claims following organizational policies and procedures. Decisions are typically are related to schedule, plans and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies.

Required Qualifications

Two (2) years of previous supervisory and/or leadership experience leading a minimum of 10 associates.

Two (2) years of experience in medical and/or institutional claims in a high production environment.

Intermediate proficiency in Microsoft Office Programs specifically, Word, Access and Excel.

Previous experience with coordinating and leading projects.

Demonstrated capability with coaching and developing associates formally and informally.

Strong business acumen including technical knowledge of claims system, and authorization systems.

Strong interpersonal, communication and presentation skills.

Ability to effectively interact with all levels of internal and external business partners.

Ability to manage time and resources to accomplish multiple tasks and meet deadlines.

Must have a separate room with a locked door that can be used as a home office, to ensure you have absolute and continuous privacy while you work.

Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.

Must reside in Tampa, FL or a commutable distance (See Additional Information for work location).

Preferred Qualifications

Associate Degrees or Bachelor's Degree.

CPC (Certified Professional Coder).

Experience supervising virtual associates.

Additional Information

Direct Reports: Up to 15 associates.

Typical Days/Hours: Monday - Friday; must be flexible to work between the hours of 5:00am - 5:00pm EST on a weekly rotating schedule and some weekends. Schedule to be determined by leadership.

Work Location: Office based position in Tampa, FL but temporarily remote. In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include: Access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, Dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Montage/Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com