What are the responsibilities and job description for the INSURANCE CLAIMS SUPERVISOR - MEDICAL (HYRBRID) position at PharMerica?
| ID | 2023-98664 | Line of Business | PharMerica | Position Type | Full-Time |
PharMerica
Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!
This role is HYBRID.
PERKS of this Insurance Claims Supervisor Opportunity:
- Flexible schedules
- Competitive pay
- Shift differential
- Health, dental, vision and life insurance benefits
- Company paid STD and LTD
- Tuition Assistance
- Employee Discount Program
- 401k
- Paid-time off
- Tuition reimbursement
- Non-retail/Closed-door environment
Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide.
If your passion is service excellence and top-quality care come join our team and apply today!
* Works in conjunction with the 3rd Party Claims Manager to establish specific associate goals, department wide goals, performance tracking and quality assessment audits.
* Establish and maintain professional and effective relationship with staff, peers, payers and other stakeholders.
* Provides associates assignments and work queues on a daily and/or weekly basis. Including resolution, billing, and appropriate distribution of work.
* Monitors quality of work performed by all associates, including interaction and compliance.
* Holds regularly scheduled meetings with staff to discuss performance metrics and ensure employees are on track to meet their goals.
* Report to Manager any trends occurring with payers and/or processes
* Updates staff with communications and process changes as directed by 3rd Party Claims Manager, Director or Senior Management and insures compliance.
* Handles escalated calls from customers and payers to ensure proper resolution.
* Mentor and provide oversight of Team Leads and Associate II staff to insure they are adequately communicating staff training needs, shadowing staff when assigned, performing monthly quality assessment reviews, and taking a lead role in any special projects that may be assigned by Supervisor or Manager.
* Manages staff attendance and time sheets for payroll (Kronos) system. Assures staff is meeting attendance policies and reports any variations to Manager.
* In conjunction with feedback provided by Team Lead and/or Associate, monitor work performance including quality
* Ensure assignments are fair and balanced based on Team Lead/Associate level skills sets.
* Works to update, create and/or maintain Standard Operations Procedures for the department.
* Ensures Sarbanes Oxley (SOX) compliance on all variance, write-off and convert exception reports inclusive of adequate signatures are obtained.
* Proper storage of completed documents per Compliance policies.
* Performs other tasks as assigned.
* Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
* Works to update, create and/or maintain Standard Operations Procedures for the department.
Education/Learning Experience
* Required: Associates degree, 4 year college , technical degree or 4 years equivalent experience
Work Experience
* Required: 3 years direct supervisory experience
* Desired: 3rd Party Billing or collections/billing experience in the healthcare industry, AS400 computer systems experience or Pharmacy Technician.
Skills/Knowledge
* Required: Proficiency in MS Office Products (Excel, Word) and Basic computer knowledge
* Required: Ability to maintain confidentiality
* Desired: AS400 Computer Systems Experience
Behavior Competencies
* Required: Excellent communication skills, both written and oral
* Required: Problem solving and detail oriented
* Required: Strong time management, organizational skills and self-starter
* Required: Strong attendance and leadership
BrightSpring Health Services, and our family of brands, provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact the BrightSpring Disabilities Support Team at 1-833-773-7240 or contact us for assistance.
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