BrightSpring Health Services

CLAIMS PROCESSING SUPERVISOR

Job Locations US-MA-TAUNTON
ID
2022-67553
Position Type
Full-Time
Line of Business
PharMerica

Our Company

PharMerica

PharMerica Logo_1250x667

Overview

3RD PARTY CLAIMS PROCESSING SUPERVISOR

 

Are you the super-star multitasker type, strong in administration skills? Our Administrative and Clerical positions support the business from multiple locations and via various functions across the nation. Read below for information on this opportunity and apply today!

Responsibilities

• Works in conjunction with the 3rd Party Claims Manager to establish specific associate goals, department wide goals, performance tracking and quality assessment audits.
• Establish and maintain professional and effective relationship with staff, peers, payers and other stakeholders.
• Provides associates assignments and work queues on a daily and/or weekly basis. Including resolution, billing, and appropriate distribution of work.
• Monitors quality of work performed by all associates, including interaction and compliance.
• Holds regularly scheduled meetings with staff to discuss performance metrics and ensure employees are on track to meet their goals.
• Report to Manager any trends occurring with payers and/or processes
• Updates staff with communications and process changes as directed by 3rd Party Claims Manager, Director or Senior Management and insures compliance.
• Handles escalated calls from customers and payers to ensure proper resolution.
• Mentor and provide oversight of Team Leads and Associate II staff to insure they are adequately communicating staff training needs, shadowing staff when assigned, performing monthly quality assessment reviews, and taking a lead role in any special projects that may be assigned by Supervisor or Manager.
• Manages staff attendance and time sheets for payroll (Kronos) system. Assures staff is meeting attendance policies and reports any variations to Manager.
• In conjunction with feedback provided by Team Lead and/or Associate, monitor work performance including quality
• Ensure assignments are fair and balanced based on Team Lead/Associate level skills sets.
• Works to update, create and/or maintain Standard Operations Procedures for the department.
• Ensures Sarbanes Oxley (SOX) compliance on all variance, write-off and convert exception reports inclusive of adequate signatures are obtained.
• Proper storage of completed documents per Compliance policies.
• Performs other tasks as assigned.
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
• Works to update, create and/or maintain Standard Operations Procedures for the department.

Qualifications

Education/Learning Experience
• Required: Associates degree, 4 year college , technical degree or 4+ years equivalent experience
Work Experience
• Required: 3+ years direct supervisory experience
• Desired: 3rd Party Billing or collections/billing experience in the healthcare industry, AS400 computer systems experience or Pharmacy Technician.
Skills/Knowledge
• Required: Proficiency in MS Office Products (Excel, Word) and Basic computer knowledge
• Required: Ability to maintain confidentiality
• Desired: AS400 Computer Systems Experience
Behavior Competencies
• Required: Excellent communication skills, both written and oral
• Required: Problem solving and detail oriented
• Required: Strong time management, organizational skills and self-starter
• Required: Strong attendance and leadership

About our Line of Business

PharMerica is a full-service pharmacy solution providing value beyond medication.  PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations.  PharMerica is one of the nation's largest pharmacy companies.  PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades.  For more information about PharMerica, please visit www.pharmerica.com.  Follow us on FacebookTwitter, and LinkedIn.

Additional Job Information

We offer a range of benefits to full-time employees to include medical, dental, vision, health care and dependent care flexible spending accounts, life, disability, paid time off, holiday, 401(k) Retirement Savings Plan, voluntary benefits, employee discounts and tuition reimbursement. Part-time employees are eligible for company paid sick leave and can participate in the 401(k) Retirement Savings Plan, dental, vision and a number of voluntary benefit offerings. 

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