Medicare Claim Supervisor (Hybrid)

About the position We are seeking a dedicated and detail-oriented Claims Manager to oversee our claims processing operations. The ideal candidate will have a strong background in medical terminology, risk analysis, and negotiation skills. This role requires an individual who can effectively manage a team, analyze claims data, and ensure compliance with Medicare guidelines and medical coding standards. The Claims Manager will play a crucial role in enhancing our claims management processes while maintaining high levels of accuracy and efficiency. Responsibilities • Oversee the daily operations of the claims department, ensuring timely and accurate processing of claims. , • Analyze claims data to identify trends, discrepancies, and areas for improvement. , • Negotiate with insurance providers and other stakeholders to resolve claim disputes. , • Ensure compliance with Medicare regulations and medical coding requirements. , • Review medical records and documentation to validate claims submissions. , • Conduct risk analysis to mitigate potential losses related to claims processing. , • Provide training and support to team members on medical terminology, DRG (Diagnosis Related Group) coding, and best practices in claims management. , • Collaborate with other departments to streamline processes and improve overall efficiency. Requirements • Proven experience in claims management or a related field, preferably within the healthcare or insurance industry. , • Strong knowledge of Medicare policies, medical terminology, and medical coding practices. , • Familiarity with auto restoration processes is a plus. , • Excellent analytical skills with the ability to interpret complex data sets. , • Demonstrated negotiation skills with a track record of successful outcomes. , • Mechanical knowledge is beneficial for understanding related claims processes. , • Ability to work independently as well as part of a team in a fast-paced environment. Nice-to-haves • Experience with auto restoration processes. Benefits • 401(k) , • 401(k) matching , • Dental insurance , • Employee assistance program , • Flexible schedule , • Health insurance , • Life insurance , • Paid time off , • Parental leave , • Retirement plan , • Vision insurance Apply Job!