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Claims Supervisor

Posted By:
Ashleigh Caplan
Posting ID:
Cambridge, Ma
 bachelor   degree 
Listing Type:Job

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Seeking an Experienced Claims Supervisor. Apply today!

Since 2004, Senior Whole Health (SWH) has been leading the way as an affordable and innovative health care plan for "dual-eligible" — people who qualify for both Medicare and Medicaid. Senior Whole Health is both an approved Medicare Special Needs Plan (SNP) and a Medicare Part D Plan. Available in Massachusetts and New York, Senior Whole Health provides members with better experiences through personal care management and comprehensive benefits. New leadership with boundless enthusiasm and a laser-sharp vision has driven significant growth; so much so, that the company is planning reaches into another state.

Claims Supervisor
Cambridge, Massachusetts

In this leadership role, you will oversee staff and Claims Department activities, basically ensuring that the quality of claims services aligns with Corporate Claims Standards. Specific responsibilities will include the provision of management support in the review, processing, adjusting and auditing of claims, and the resolution of claims errors or issues through communication and collaboration. You will create reports based on trends identified through the analysis of data, and identify, develop and implement new claims processes, procedures, and solutions as needed. Finally, you will apply your knowledge of applicable laws, regulations and compliance requirements to ensure claims are processed according to HIPAA, state and federal-specific regulations.

To qualify, you should hold a Bachelor’s degree (preferred), and possess 5 years of supervisory experience in Managed Care claims, preferably, Medicare claims. Your background must emphasize knowledge of the claims life cycle, medical terminology, ICD-9, CPT, and HCPCS. You must be able to build and maintain good working relationships with providers, and lead team members in a positive, productive manner. Proficiency in MS Office products, including MS Word, Excel and PowerPoint is needed, along with excellent verbal and written communication skills.

Working with Senior Whole Health, you’ll enjoy a competitive compensation and benefits package that provides medical, dental and vision coverages, and paid vacations and holidays. You’ll also appreciate the stability of an enduring career with a solid, successful company.

Join the company that cares! Send your resume and letter of interest to us. Please be sure to specify, “Claims Supervisor – 37381B” in the subject line.

Senior Whole Health is an Equal Opportunity Employer.

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