Supervisor, Claim Adjudication Operations
United StatesFull-TimeManager
SalaryUSD 63927.28 - 76900.12 / year
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Job Details
- Experience
- 4 years of experience required.
- Required Skills
- Process improvementHIPAA
Requirements
- Bachelor’s degree or equivalent work experience.
- Minimum 4 years of professional experience.
- Professional PBM (Pharmacy Benefit Management) industry experience is preferred.
- Knowledge of data privacy practices and laws is preferred.
- Healthcare industry knowledge and HIPAA familiarity are a plus.
- Understanding of human resource management principles, practices, and procedures is a plus.
- Ability to work in a multi-disciplinary team environment.
- Strong interpersonal skills for collaborating with diverse team members and stakeholders.
- Ability to negotiate and manage different personalities across departments.
Responsibilities
- Oversee roles within the Claim Adjudication Operations department to support accurate and timely configuration and data transfers.
- Provide superior customer service utilizing a high-touch, customer centric approach focused on collaboration and communication.
- Outreach and collaborate with CAO customers/partners for day-to-day work and contribute to action plan creation.
- Manage department Kanban boards, meeting turnaround times and performance guarantees.
- Coordinate resource assignment for daily work, audits, and root cause analysis.
- Perform 1:1 meetings for mentorship, career development, performance management, and workload guidance.
- Conduct workforce management duties including time tracking and overtime oversight.
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