Claims Examiner Supervisor
Company: Conifer Health Solutions
Posted on: January 13, 2022
As a part of the Tenet and Catholic Health Initiatives family,
Conifer Health brings 30 years of healthcare industry expertise to
clients in more than 135 local regions nationwide. We help our
clients strengthen their financial and clinical performance, serve
their communities and succeed at the business of healthcare.
Conifer Health helps organizations transition from volume to
value-based care, enhance the consumer and patient healthcare
experience and improve quality, cost and access to healthcare. Are
you ready to be part of our solutions? Welcome to the company that
gives you the resources and incentives to redefine healthcare
services, with a competitive benefits package and leadership to
take your career to the next step!JOB SUMMARY Responsible for the
resolution of claims issues, including partnering with client
delivery and providers.ESSENTIAL DUTIES AND RESPONSIBILITIESInclude
the following. Others may be assigned.
- Supervise a team of claims personnel.
- Manage claims inventory for multiple companies according to
state and federal guidelines utilizing inventory management systems
- Team with other departments to resolve departmental/employee
- Review and update policies and procedures.
- Manage the work behaviors of all subordinate staff. Coach,
counsel and reward as appropriate to individual performance.
Deliver monthly/annual performance reviews.SUPERVISORY
RESPONSIBILITIES If direct report positions are listed below, the
following responsibilities will be performed in accordance with
guidelines, policies and procedures and applicable laws.
Supervisory responsibilities include interviewing, hiring, and
training employees; planning, assigning and directing work;
appraising performance; rewarding and disciplining employees;
addressing complaints and resolving problems. Direct Reports
(titles) Claims Leads, Claims Examiners, Project Coordinators,
Conifer requires its candidates, as applicable and as permitted by
law, to obtain and provide confirmation of all required
vaccinations and screenings prior to the start of employment. This
may include, but is not limited to, the COVID-19 vaccination,
influenza vaccination, and/or any future required vaccines and
screenings.KNOWLEDGE, SKILLS, ABILITIESTo perform this job
successfully, an individual must be able to perform each essential
duty satisfactorily. The requirements listed below are
representative of the knowledge, skill and/or ability required.
Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions.
General office equipment
experienceMust have an excellent understanding of health and
managed care concepts and their application in the adjudication of
claims.Strong working knowledge of ICD.9.CM, CPT, HCPCS, RBRVS
coding schemes and medical terminology.EDUCATION /
EXPERIENCEInclude minimum education, technical training, and/or
experience preferred to perform the job.
High School Diploma or Equivalent5-6
years Supervisory/Management experience preferred. 2-3 years claims
experience in a managed care environment preferred.PHYSICAL DEMANDS
The physical demands described here are representative of those
that must be met by an employee to successfully perform the
essential functions of this job. Reasonable accommodations may be
made to enable individuals with disabilities to perform the
- Must be able to work in sitting position, use computer and
answer telephoneAbility to travel (minimal)Light physical effort
(lift up to 10lbs). Regularly needs to be able to bend, stoop and
reach to file.WORK ENVIRONMENT The work environment characteristics
described here are representative of those an employee encounters
while performing the essential functions of this job. Reasonable
accommodations may be made to enable individuals with disabilities
to perform the essential functions.
Office Work EnvironmentJob: Conifer
Health SolutionsPrimary Location: Encino, CaliforniaJob Type:
Full-timeShift Type: DaysEmployment practices will not be
influenced or affected by an applicant 's or employee 's race,
color, religion, sex (including pregnancy), national origin, age,
disability, genetic information, sexual orientation, gender
identity or expression, veteran status or any other legally
protected status. Tenet will make reasonable accommodations for
qualified individuals with disabilities unless doing so would
result in an undue hardship.
Keywords: Conifer Health Solutions, Torrance , Claims Examiner Supervisor, Other , Torrance, California
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