Government Program Claims Supervisor Job in Springfield 01144, Massachusetts US
Summary:
This role will lead, maintain and enhance the Medicare and Medicaid claims processing services on the Amisys computer system and through vendors. This will be achieved through a customer, provider, government and financial driven quality, timeliness and compliance expectation. Manage relationships with vendors, medical management, compliance, member, and provider service. Provide business content expertise in administrative, contractual and technical aspects for claims, adjustments, document processing and reporting, and government claims projects and initiatives.
Requirements:
Bachelor’s degree and more than 3 years of advance level experience in health care insurance claims administration, or an equivalent combination of education and experience.
· Experience with processing Medicare and/or Medicaid claims is required
· Knowledge and understanding of Massachusetts Division of Insurance, CMS, ERISA and HIPAA standards and regulations
· Strong knowledge of Medicare and Medicaid policies and procedures specific to claims processing, including industry standards, medical terminology and standardized coding mechanisms
· Knowledge of Amisys a plus
· Strong computer technology skills
· Demonstrated leadership skills
· Critical thinking and basic project management skills
· Excellent verbal and written communication and presentation skills
· Excellent interpersonal skills; demonstrated ability to work with teams, both in leadership and participant capacity
· Ability to meet deadlines with minimal supervision; to coach and motivate with diplomacy and supportiveness; and to manage multiple tasks with constant shifting priorities
· Office environment
· Must be able to work at a personal computer for extended periods of time
· Able to sit for extended periods of time
EOE/AA Smoke Free Environment
