United States onlyCentivo is seeking a Claims Supervisor in Management Ancillary Services (CMAS) to oversee claim processing functions related to claims adjudication, appeals, escalations, quality, and recovery. The Supervisor will have direct management of a team that supports, researches, and resolves the accurate processing of healthcare claims for employer-sponsored health plans.
Requirements
- Demonstrates knowledge and understanding of benefit administration for self-funded healthcare plans
- Ensures that claims, appeals, and adjustments are processed and paid in accordance with benefit plans, pricing agreements, and required authorizations
- Manages the inventory of claims against standard service level agreements (SLA’s)
- Educates and mentors claims staff to ensure proper application of client benefit plans to claims processed, at the required quality and production metrics
- Provides reports to department leaders on claim inventory, production, turn-around lag, and quality metrics
- Develops policy and procedures to ensure that benefit plans and claim standards are properly administered
- Accountable for positively influencing the morale of the department employees
- Liaison for the CMAS Team on various projects and/or initiatives
Benefits
- Health insurance
