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Supervisor Provider Claims Service

Company: Amerihealth
Location: Jacksonville
Posted on: July 22, 2021

Job Description:

Your career starts now. We’re looking for the next generation of health care leaders.

At 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 www.amerihealthcaritas.com.

Responsibilities:

Responsible for supervising the day-to-day operations of the PCS contact center.  Direct supervision of 15-20 PCS Contact Center Associates.  Manage Provider contact on claim issues, claims payment, claim adjudication, member eligibility and coverage, and all claims issues as it relates to payment.  Supervision of staff including training, development, coaching, mentoring, and counseling.  Partner with Workforce Management team to ensure daily attainment of all Service Levels.  Ensure Provider satisfaction through daily monitoring of phone calls to ensure calls are being handled properly with a focus on “first call closure”. Ensure procedures are being adhered to and manage team to attain contractual and internal Quality goals.  Participate in meetings for new and current business with Health Plan. Participate in application testing and work closely with IS to address system issues as they affect the Contact Center.  Interview, select, train and coach associates.  Monitor schedule adherence and manage attendance.

Education/Experience:

  • 1 to 3 years' supervisory experience in a contact center environment.
  • High School/GED required
  • Bachelors Degree preferred.
  • Healthcare claims experience preferred. 
  • Customer Service Contact Center experience
  • Basic knowledge of medical terminology, CPT and ICD codes.
  • Knowledge of Microsoft Word, Excel and Outlook.

Keywords: Amerihealth, Jacksonville , Supervisor Provider Claims Service, Other , Jacksonville, Florida

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