Supervisor Claims

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click .

Applicants must be eligible to begin work on the date of hire. Applicants must be currently authorized to work in the United States on a full-time basis.

ARKANSAS BLUE CROSS BLUE SHIELD will NOT sponsor applicants for work visas in this position.

Arkansas Blue Cross is only seeking applicants for remote positions from the following states :

Arkansas, Florida, Georgia, Illinois, Kansas, Louisiana, Minnesota, Mississippi, Oklahoma, South Carolina, Tennessee, Texas, Virginia and Wisconsin.

Workforce Scheduling

Remote

Job Summary

Claims Supervisor oversees and monitors all claims processing functions within the team and ensures high service levels and performance standards are met.

Incumbent maximizes resources within the claims team by identifying training needs and determines and implements methods to enhance the skills of Claims Specialists.

Requirements

EDUCATION

Bachelor's degree in related field. In lieu of degree, five (5) years' experience as a Level III or above Claims Specialist, or claims processing in a hospital business office, medical provider's office or other health insurance company functioning in a lead role will be considered.

EXPERIENCE

Minimum five (5) years' experience as a Level III or above Claims Specialist, or claims processing in a hospital business office, medical provider's office or other health insurance company functioning in a lead role.

OR applicable Masters in related field with minimum three (3) years' experience.

Minimum one (1) year Amisys or ITS claims inquiry or processing experience.

Minimum one (1) year experience with Microsoft Word and Excel.

Demonstrated success as an individual contributor in current or related operational / functional area. Exhibits ability to coach and train others;

possesses organizational and planning skills. May have team leader experience.

ESSENTIAL SKILLS & ABILITIES

Presentation skills (presentation may be required during interview).

Planning & organization

Coaching / training

Skills

Ability to work independently, Active Listening, Coaching, Communication, Delegation, Employee Engagement, Leadership, Mentoring, Problem Analysis, Processing, Project Management, Teamwork, Technical Writing, Virtual Teams

Responsibilities

Assists in development of claims training materials and conduct strength training sessions as needed., Attends meetings (including giving presentations) in the absence of the Claims Coordinator or Manager on an as needed basis.

Develops and implement processes to ensure accurate and effective claims processing., Identifies training needs based on feedback from audits, claims processing data, and personal observation.

Keeps Claims Coordinator advised of key issues and trends., Oversees and monitors all claims processing functions within the team and ensures high service levels.

Provides technical expertise regarding claims processing., Provides technical expertise regarding the AMISYS system and interact with the Configuration and Analysis Team regarding system enhancements, testing, and system issues.

Sets goals, objectives and standards of performance for the team. Give individual feedback on a regular basis., Supervises claims team and provides direction in order to meet division and MTM standards.

Supervises the hiring, coaching / training, employee development and performance management of assigned team. , Works closely with team members and other internal staff to resolve any issues in a prompt manner.

Certifications

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained.

The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business.

This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.