• Supervisor Paper Claims and Intake

    AmeriHealth CaritasPhiladelphia, PA 19133

    Job #1373572630

  • Supervisor Paper Claims and IntakeLocation: Philadelphia, PAPrimary Job Function: OperationsID: 19412Your career starts now. We're looking for the next generation of health care ~~~ AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at ~~~ .Responsibilities:This position will provide supervisory oversight to Paper Claims Intake and Oversight unit, developing approaches for the end to end Health Service Payment and Appeals process to ensure maximum effectiveness and efficiency.Applies advanced subject matter knowledge to complex business issues, and is regarded as a subject matter expert for back office processes or applications. This includes claims, enrollment, invalid provider data functions and appeals. Frequently contributes to the development of new ideas and methods. Works on complex problems/projects where analysis of situations or data requires an in-depth evaluation of multiple factors. Exercises significant independent judgment within broadly defined policies and practices to determine best method for accomplishing work and achieving objectives. Responsible for developing and designing reports to be communicated to Sr./Executive Management. Leverage data from disparate data sources to create actionable business intelligence for Business Executives. Leads and provides expertise to functional project teams and may participate in cross-functional initiatives. As needed, will assist the department with writing business requirements and work requests for improvement opportunities. Acts as expert providing direction and guidance to process improvements as well as establishing policies and on line help documentation. Manages, provides guidance and oversight to a small staff of business analysts.Education/ Experience:+ Bachelor's Degree.+ 3-5 years of previous managerial and analytical experience in an operations environment.+ Experience defining problems, collecting data, establishing facts, and recommending solutions.+ Demonstrated ability to clearly communicate (written and oral) problems and solutions to all levels of an organization.+ Skilled interpersonal communication and customer service.+ Ability to work with and through others to achieve results.Other Skills:**+ Healthcare experience strongly preferred.+ Six Sigma Black Belt or PM certification preferred.+ Prior experience with Facets claims system, EXP Docflow or similar customer service applications preferred.EOE Minorities/Females/Protected Veterans/Disabled