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Jobs/Claims Examiner Role/anglehealth - Claims Supervisor
anglehealth

anglehealth - Claims Supervisor

San Francisco, California, United States - Hybrid+ Equity2mo ago
In OfficeAPACInsurancePublic SectorHealthcareClaims ExaminerTeam LeadershipDocumentationTraining DevelopmentQuality AssuranceProcess Improvement

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Responsibilities

• Team Leadership: Lead a team of dedicated professionals with a focus on delivering timely, high-quality claim outcomes. • Operations Oversight: Monitor daily claim processing activities to ensure established performance metrics and service-level standards are consistently met. • Quality Assurance: Ensure all claim processing complies with internal policies as well as state and federal regulations. Participate in control audits and implement corrective action plans as needed. • Documentation: Develop, write, and maintain resource documents to support team accuracy and serve as reliable reference materials. • Issue Resolution: Serve as an escalation point for complex or disputed claims, customer concerns, and provider inquiries, ensuring timely and professional resolution. • Process Improvement: Analyze claim data to identify trends and opportunities for operational enhancement; collaborate with the Head of Claims to implement prompt and effective solutions. • Training & Development: Create individualized training plans and collaborate with the team’s dedicated trainer to support continuous growth and development for each team member. • Knowledge: Strong understanding of healthcare claims adjudication, medical terminology, and coding systems (ICD-10, CPT). • Startup Experience: Knowledge of and/or hands-on experience working in a startup environment. • Skills: Excellent leadership, problem-solving, analytical, and communication skills. Proficiency in claims management software. • Google Drive and Google Sheets

Benefits

• Competitive salary and equity compensation. • Flexible work arrangements (hybrid or remote considered). • Opportunity to work with a mission-driven team transforming healthcare

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