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Health Plan Claims Supervisor
VirtualVocationsBuffalo, New York, United Statesjob_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Supervisor, Health Plan Claims Operations.
Key Responsibilities
Oversee claims quality and timeliness of payment, ensuring compliance with regulations
Manage TPA operations and monitor service delivery against SLAs
Identify and implement process improvements to enhance operational efficiency and member satisfaction
Required Qualifications
Bachelor's degree or 6+ years of relevant healthcare operation experience
Four years of experience managing healthcare operation teams, including claims and billing
Strong knowledge of ACA / IFP and commercial claim requirements
Experience in oversight management of TPA operations
Background in developing and reviewing operational SOPs and business requirement documents
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Health Plan • Buffalo, New York, United States
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