Supervisor Medical Claims
- Milwaukie, OR
- Permanent
- Full-time
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.Position Summary
Provides supervision, coaching and support to Claims Processors. Organizes staff, sets goals, establishes procedures, and continues to ensure claims are processed promptly and accurately. Measures and evaluates performance and results. Coaches and trains as required to achieve goals of quality and efficiency. This is a FT WFH role.Pay Range
$58,747.10 - $73,433.88 annually, DOE.
*This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.Please fill out an application on our company page, linked below, to be considered for this position.
https://j.brt.mv/jb.do?reqGK=27761701&refresh=trueBenefits:
- Medical, Dental, Vision, Pharmacy, Life, & Disability
- 401K- Matching
- FSA
- Employee Assistance Program
- PTO and Company Paid Holidays
- 2 – 4 years medical claims processing experience, including 1 year as Senior/Lead processor.
- Computer proficiency in company’s systems and Word and Excel.
- Strong verbal, written and interpersonal communication skills.
- Strong analytical, problem solving and decision-making skills.
- Ability to work well under pressure with frequent interruptions and shifting priorities.
- Ability to come in to work on time and daily.
- Maintain confidentiality and project a professional business image.
- Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
- Controls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality.
- Assists with planning by analyzing amount of work and type of work, assigns and sets priorities and decides on retraining needs.
- Motivates and coaches the processors by reviewing results with them, conveys to them what is expected of them, asks for suggestions, and fulfills the needs of training.
- Use and manipulate excel files.
- Other duties as assigned
- Internally with staff, Underwriting, Professional Relation, Claims Support, Accounting, and IT. Externally with providers, policyholders, insureds, and brokers.