Job: Supervisor, Claims Operations

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Jobing Description

Monarch HealthCare, Where Great Careers Begin!

Monarch HealthCare has been recognized as one of "Orange County‚s Top Places to Work" for three consecutive years! Our employees set us apart!
Monarch HealthCare has been chosen for innovative National Healthcare Program! "Accountable Care Organizations" will help improve quality and lower costs! We are one of the five named "ACO‚s" throughout the country.

Monarch HealthCare is a medical group ("IPA") of over 2600 independent physicians in private practice dedicated to practicing medicine the way it was meant to be. Monarch HealthCare is owned and operated by doctors who believe in working collaboratively with all stakeholders to improve the delivery of healthcare in the communities we serve. We are an industry leader in providing coordinated care! Our commitment to our employees and our employee dedication to our physicians and patients is what differentiates us.

We are currently searching for an experienced Claims Supervisor. In this supervision role, you will be responsible for supervising the day to day claims processing operations, providing direct leadership and supervision to staff, ensuring full compliance with performance, policies and all regulatory procedures along with building and fostering collaborative working relationships.


Responsibilities:

* Coordinate day to day claims operations tasks in accordance with established policies and procedures, standard operating procedures, and job aids to ensure optimal performance results
* Administer the contractual compliance of claims inventory/workflow through the entire claim life cycle to ensure timely processing to ensure compliance with all regulatory agencies.
* Promote operational excellence though development, implementation and management of departmental monitoring tools, controls, policy and procedures
* Drive team results based upon established departmental quality and production performance metrics
* Collaborate with Compliance, Regulatory and training teams to ensure successful audits, identify opportunities for staff development to maximize claims outcomes

Skills / Requirements

* 5 years related experience or training in a health care, medical group or related setting; minimum 3 years previous experience at the manager or supervisor level
* Previous experience working in EZCAP a plus
* In depth knowledge of regulatory compliance requirements mandated by CMS, DHS, and the DMHC
* Strong working knowledge of MS Office products; Excel, Word, and Outlook
* Able to build strong working relationships with cross functional team and among members of the organization at different levels
* Strong team building and leadership skills; able to mentor, motivate and inspire others


To apply for this position, please select the "apply on line" option or send a resume to resume@mhealth.com

Monarch HealthCare has assembled a competitive compensation package that recognizes the many contributions by our dedicated employees and strives to keep our employees as satisfied, long term business partners! Our competitive salary, robust employee health plans, generous retirement package and "work-life balance" vacation schedules are the cornerstone of our employee friendly health and welfare plans!


For a detailed job description on this great career opportunity, all of our open positions or more information on our complete benefit package; please visit our career site at www.monarchhealthcare.com


"Helping Physician Partners Advance Medical Excellence in the Communities We Serve"