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Claritev · 17 hours ago

Coordination of Benefits - Supervisor

United States

Full-time

Onsite

Senior Level

$65K/yr - $72K/yr

5+ years exp

Claritev is a dynamic team focused on transforming healthcare through technology and innovation. The Coordination of Benefits - Supervisor role ensures accurate processing of benefits identification and validation while managing team performance and compliance with regulations.

BillingHealth CarePayments

Responsibilities

Schedules and prioritizes work, approve time off, conducts performance reviews, hires, and trains new employees, and performs other supervisory responsibilities and enforces production, quality, and customer-service standards / SLAs. Addresses issues with the team as a whole and individually

Primary point of contact for offshore contractors, including but not limited to the following: hiring for correct skillset, work assignment, approving hours, coordinating training, mitigating vendor specific issues, and working with vendor management to drive acceptable results

Partners with senior leadership to draft, develop, and implement policies, procedures, and strategies to improve department metrics and relevant KPIs

Routinely utilizes expertise specific to coordination of benefits rules, regulations, methodologies, and audit tactics to ensure efficient day-to-day operation of the department

Ensures compliance with CMS, NAIC and state COB guidelines. Ensures team is following company and client expectations

Works closely with senior leadership to document policies, procedures, and processes. Maintains and improves COB/OHI processes by monitoring trends and addressing issues for process improvement

Must maintain a high level of confidentiality in dealing with protected health information and ensure that teams do the same

Fields client issues and complaints and decides on a course of action to resolve the matters

Select, develop, and evaluate staff to ensure the efficient operation of department

Collaborate, coordinate, and communicate across disciplines and departments

Ensure compliance with HIPAA regulations and requirements

Demonstrate Company's Core Competencies and values held within

Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role

The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary

Qualification

Healthcare operations experienceSupervisory experienceCoordination of Benefits expertiseMS Office proficiencyClient focusProblem solving skillsAnalytical skillsIndependent decision makingOrganizational skills

Required

Minimum high school diploma plus five (5) years experience in healthcare/insurance operations, coordination of benefits, or claims processing environment; two (2) years' of which should be inclusive of supervisory or other leadership experience

History of demonstrated client focus and ability to achieve results

Required licensures, professional certifications, and/or Board certifications as applicable

Clinical jobs require post-graduate experience in direct patient care, board certification for MD/DO (Medical Doctor/Doctor of Osteopathic Medicine), and an unrestricted clinical license

Good organizational, analytical and independent decision making skills

Strong problem solving skills with the ability to manage multiple priorities and meet associated timelines

Proficient with MS Office products including Microsoft Excel

Specifications should support the essential functions identified in the job, assuring compliance with the Americans with Disabilities Act (ADA) and other such employment-related acts (i.e., ability to stand for long periods of time, ability to interact with customers or visitors, ability to lift up to 50 pounds, ability to travel)

Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone

Benefits

Medical, dental and vision coverage with low deductible & copay

Life insurance

Short and long-term disability

Paid Parental Leave

401(k) + match

Employee Stock Purchase Plan

Generous Paid Time Off - accrued based on years of service

10 paid company holidays

Tuition reimbursement

Flexible Spending Account

Employee Assistance Program

Sick time benefits - for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits

Company

Claritev

Glassdoor3.8

Claritev is an independent and public healthcare technology, data and insights company making healthcare more transparent, fair and affordable for all.

Founded in 1980

Mclean, Virginia, USA

1001-5000 employees