Claims Supervisor- Bakersfield 1.1 at Universal Healthcare MSO LLC

Bakersfield, California, United States -

Full Time

Start Date

Immediate

Expiry Date

31 Mar, 26

Salary

35.58

Posted On

31 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Processing, Supervisory Experience, Coaching, Workflow Oversight, Regulatory Compliance, Claims Inventory Management, Performance Feedback, Collaboration, Troubleshooting, Process Improvement, Organizational Skills, Analytical Skills, Communication Skills, Microsoft Excel, Microsoft Word, Claims Systems

Industry

Hospitals and Health Care

Description

Description Employment Details: Location: Bakersfield Employment Type: Full-Time FLSA Status: Non-Exempt- This position is non-exempt and will be paid on an hourly basis. Schedule: Monday-Friday 8am-5pm Benefits: · Medical · Dental · Vision · Paid Time Off (PTO) · Floating Holiday · Simple IRA Plan with a 3% Employer Contribution · Employer Paid Life Insurance · Employee Assistance Program Compensation: The initial pay range for this position upon commencement of employment is projected to fall between $28.47 and $35.58. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you. Position Summary: The Claims Supervisor provides hands-on leadership and operational oversight within the Claims Department, ensuring timely, accurate, and compliant claims and encounter processing. This role supervises staff, monitors productivity and quality standards, manages claims inventory, and supports workflow efficiency. The Claims Supervisor works closely with internal departments, including Enrollment and Information Technology, to support accurate adjudication and effective system functionality. This position helps implement operational improvements, staff training, and process enhancements while maintaining compliance with regulatory and contractual requirements. Job Duties and Responsibilities: · Supervise daily claims operations, ensuring timely, accurate processing of claims and encounters. · Monitor claims inventory and production reports to maintain productivity and quality standards. · Coach, train, and provide performance feedback to claims staff. · Support adherence to claims workflows, policies, and procedures. · Ensure compliance with regulatory, contractual, and health plan requirements. · Identify staff training needs and coordinate appropriate support. · Collaborate with Enrollment and internal departments to ensure accurate claim processing. · Assist in troubleshooting system issues and support process improvement initiatives. · Provide feedback to management on workflow, productivity, and operational challenges. · Participate in departmental meetings and support cross-functional initiatives as needed. · Assist with onboarding and performance management of claims staff. · Ensure staff have the tools and resources needed to perform their job functions. · Perform other related duties as assigned. Requirements Qualifications · High School Diploma or GED required, associate or bachelor’s degree in healthcare administration, Business, or a related field preferred. · Minimum of 5 years of experience processing professional and institutional claims within a managed care environment, preferably in an IPA or medical group setting. · Supervisory experience preferred, including coaching and workflow oversight. · Strong knowledge of professional and institutional claim processing. · Knowledge of fee schedules and pricing methodologies for inpatient, outpatient, ancillary, and professional claims. · Familiarity with CMS, DMHC, and DHS regulations. · Coding certification (CPC, CCS, or equivalent) strongly preferred. · Experience with claims systems and workflow automation. · Understanding of health plan financial responsibility structures and provider contract interpretation. · Strong organizational, analytical, and communication skills. · Proficiency in Microsoft Excel, Word, and email. Other Requirements: · Possession of a valid driver's license. · Proof of state-required auto liability insurance.

Responsibilities

The Claims Supervisor oversees daily claims operations, ensuring timely and accurate processing of claims. This role includes supervising staff, monitoring productivity, and implementing operational improvements.