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Supervisor, Claims- Hybrid
- UPMC (Pittsburgh, PA)
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UPMC Health Plan is hiring a full-time Supervisor, Claims for their operations department. This role requires management level experience in planning, directing. In this role you would be responsible for training personnel, preparing and giving evaluations to employees, and maintaining excellent working relationships with all departments. As the Supervisor, Claims you would be responsible for team performance, including accurate and timely completion of assigned claim inventories. You would ensure effective employee development and training. The Supervisor must use their knowledge and understanding of claim inventory trends and other information generated to identify opportunities to improve claim performance.
This position follows a hybrid work model, with on-site presence at the Downtown Pittsburgh office required as needed.
Responsibilities:
- Manage special projects
- Work in conjunction with other Supervisors to allocate and adjust team resources as daily needs required
- Identify trends and partner with the Support team and Management to make recommendations and improve operational
performance
- Participate in interviewing, hiring, and training of team members
- Enhance communication via effective team meetings, huddles, and employee one on ones
- Ensure team performance meets or exceeds claim timeliness and quality standards for regulatory compliance and
performance guarantees
- Meet deadlines and turnaround times set by management (these deadlines and turnaround times will, at times, require
the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both)
- Maintain a positive work environment through employee recognition and interaction
- Strategize, plan, organize, and execute efficient inventory management
- Supervise and monitor the ongoing performance of team members. Continually examine team performance against
department standards. This includes timely employee feedback via employee scorecards
+ Bachelor's degree in business, health care or management related field or equivalent experience
+ Minimum 3 years of health insurance experience preferred
+ Minimum 3 years leadership experience (leading, mentoring, coaching, or teaching)
+ Excellent planning, communication, documentation, organization, analytical and problem solving abilities
+ Medical Terminology or medical billing experience
+ High level of professionalism, enthusiasm, and initiative on a daily basis
+ Working knowledge of Commercial, Medicaid and Medicare plans
+ Working knowledge regarding Coordination of Benefits
+ Ability to maintain quality and production designated standards established for handling work, problem solve effectively and organize workflow
+ Ability to handle multiple priorities in a fast-paced production environment
+ Some travel may be required
+ Must be able to serve as a positive extension of the management team. **Licensure, Certifications, and Clearances:** **UPMC is an Equal Opportunity Employer/Disability/Veteran**
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