Medical Claims Supervisor

Description

Lifeworks is seeking a Medical Claims Supervisor. The Medical Claims Supervisor is responsible for coordinating and supervising day-to-day operations of the claims processing functions, including research and resolution of unpaid claims, along with ensuring the work is completed in a timely and accurate manner. 

Position Title: Medical Claims Supervisor

Department: Finance

Hours:  Full-time [40] hours/week, Monday – Friday (Exempt)

Location: Lifeworks Services – Richfield/ Hybrid (20% in-person)

Compensation: $58,240-$62,400/year.

Lifeworks offers a comprehensive benefits package which includes:

• 18 days of PTO accrued in the first year of employment
• 11 paid holidays (New Year’s Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Thanksgiving, Day after Thanksgiving, Christmas Eve, Christmas Day, and a Personal Holiday)
• Medical, dental, vision, life, AD&D insurance, short & long-term disability coverage
• Health Savings Account (HSA), Flexible Savings Account (FSA), and prescription drug coverage
• Up to $3,000 annually in tuition reimbursement
• 403(b) retirement plan – Lifeworks contributes 3% of your salary and matches up to 4% of employee contributions
• Employee Assistance Program (EAP)

Why Work at Lifeworks

Lifeworks is an industry leader on the forward edge of partnering with people with disabilities in innovative, person-centered ways. Disability inclusion is our true north, guiding every service we provide and ensuring that people with disabilities have opportunities, can thrive, and defy expectations. The Lifeworks Team is collaborative, passionate, and strategic, using a person-centered approach to increase access in our communities.

You’ll succeed in this role if you:

• Have strong analytical and problem-solving skills.
• Have experience with medical claim management and medical billing software systems.
• Have demonstrated leadership and staff development skills and ability to establish and cultivate strong relationships.
• Are capable of performing the essential functions of the job, with or without reasonable accommodations.
• Have the ability to understand and communicate written and verbal directions.
• Have regular attendance, reliability and punctuality is necessary to meet the needs of the business.
• Are well organized with excellent attention to detail.
• Have an aptitude to work independently with excellent time management skills.
• Have experience working effectively with others to reach common goals and objectives.
• Are skilled at establishing and cultivating strong relationships. 
• Have the ability to take initiative and strengthen relationships with current and new community. 

• Supervise the organization’s medical claims / Medicaid billing, collections, and customer accounts in compliance with generally accepted accounting principles (GAAP), government and private contracts, and Health Insurance Portability and Accountability Act (HIPAA).
• Select, supervise, develop, motivate, and retain accounts receivable and billing staff. Responsibilities include coaching, goal setting, career counseling, providing daily work direction, recognizing and reinforcing desired performance.
• Participate in and support, system and state mandated changes while maintaining days sales outstanding to 30 days or less.
• Point of contact for analyzing and researching why specific customer accounts remain unpaid, working across program teams to resolve problematic claims.
• Validate claims data by conducting regular internal audits to ensure overall timely and accurate adjudication, processing, and payment of claims or claims adjustments.
• Insure proper segregation of duties and overall compliance with insurance and/or government contracts.
• Participate in system changes or upgrades as a subject matter expert regarding the medical claims processing functions and suggest necessary improvements for compliance to provider requirements, efficient processing, and accuracy in claims processing.
• Maintain current understanding of medical claims processing as it relates to medical billing including Medicaid service regulatory changes, insurance contracts, and overall medical billing practices.
• Work collaboratively with program services, IT, Compliance, HR, and Payroll, providing excellent customer service, improving processes and the delivery of projects and initiatives.