Veterans, Reservists, Guardsmen and military family members are encouraged to apply!!
We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only)
Job Summary
This position is responsible for the daily oversight of a production-based team that handles medical and facility claims for both Veterans and providers. Claims supervisors manage multiple work types including, but not limited to, the review of claims, reconsiderations, correspondence, provider inquires, and escalated issues. The role will require regular interaction and collaboration with Veterans, providers, sub-contractors, and TriWest leaders.
Education & Experience
Required:
- High School diploma or GED
- 4+ years of experience with health care claims processing, billing, or other related functions
- Experience with interpretation of written policy and automated transactions
- Team lead, training, or subject matter expert experience
Preferred:
- Associate degree in related field
- Experience in a supervisor or leadership role
- Advanced Access and Excel skills
- Claims pricing experience
- Claims coding experience
Key Responsibilities
Assists in the development and implementation of department policies and training.- Audits completed work, performs analysis of results, and provides coaching for improvement.
- Responsible for the daily supervision of staff, including multiple job roles.
- Manages inventory and team’s work assignments.
- Proactively identifies opportunities and collaborates with leaders and subcontractors to drive issue resolution.
- Coordinates with leadership, direct reports, and project teams regarding process changes.
- Works with other TriWest departments on escalated issues.
- Recommends quality and productivity improvements to enhance service to all Veterans and providers.
- Exhibits professionalism in all written and verbal communication.
- Hires, evaluates, and develops staff members.
- Assesses team performance, initiates corrective action plans, and writes annual reviews.
- Provides telephonic customer service assistance to government employees, providers, and Veterans.
- Performs other duties as assigned.
- Regular and reliable attendance is required.
Competencies
Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation.
Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts to different styles; listens critically; collaborates.
Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.
Information Management: Ability to manage large amounts of complex information easily, communicates clearly, and draws sound conclusions.
Leadership: Successfully manages different styles of employees; provides clear direction and effective coaching.
Multi-Tasking / Time Management: Prioritizes and manages actions to meet changing deadlines and requirements within a high volume, high stress environment.
Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.
Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.
Technical Skills: Expertise with healthcare claims processing and claims research; government healthcare claims experience; ability to document trends and assimilates data.
Working Conditions
Working Conditions:
- Works within a standard office environment, with minimal travel
- Extensive computer work with long periods of sitting