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Supervisor, Claims Services (HMSA BlueCard)
Exempt or Non-ExemptExempt
The Supervisor is responsible for mentoring, coaching, and providing direction to an operational area. The Supervisor also monitors the processing and adjudication of claims and inquiries to ensure performance objectives are met. The Supervisor also supports the implementation of changes to the operational areas due to business initiatives, system enhancements, and process improvements.
- Bachelor's degree and three (3) years of related work experience; or equivalent combination of education and related work experience.
- One (1) year of supervisory experience.
- Excellent communication and coaching skills.
- Good PC navigational skills and proficient in Microsoft Office.
Duties and Responsibilities
- Select, train, and develop knowledge, job skills, and core competencies of the staff to maximize productivity and meet the unit's objectives. Following the corporate Performance Management Program (PMP) process, establish individual objectives and performance standards that support the unit, department, and corporate goals. Provide feedback and coaching to reinforce and reward behaviors which build a corporate culture that is in line with HMSA's vision & mission.
Production ManagementOversee operational unit:
- Organize, direct and guide operational staff according to business requirements and objectives.
- Monitor operational reports for performance fluctuations and trends to effectively manage inventory.
- Participate in interdepartmental discussions regarding business initiatives, operational workflows, and process improvements.
- Initiate or respond to communications with providers, members, BlueCross Blue Shield Association, and other Blue Cross Blue Shield plans.
- Participate and support internal or external claims audit activities. Develop and maintain proper controls to ensure operational effectiveness. Implement corrective actions; adjust training and/or workflow procedures as appropriate.
- Collaborate with management team on the development of unit business plan, resource plan, and budget.
- Support and participate process improvements, innovation activities, and other corporate events.
- Represent unit in production support and project meetings.
- Attend and complete HMSA training and compliance activities as required.
- Other duties as assigned.