Claims Supervisor in Portsmouth, NH at Public Consulting Group

Date Posted: 7/9/2020

Job Snapshot

Job Description

Overview

About Public Consulting Group

Public Consulting Group, Inc. (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,500 professionals in more than 60 offices worldwide. PCG’s Health practice offers in-depth programmatic knowledge and regulatory expertise to help state and municipal health agencies respond to regulatory change, improve access to health care, maximize program revenue, improve business processes, and achieve regulatory compliance. Using industry best practices, PCG’s Health team helps organizations deliver quality services with constrained resources to promote improved client outcomes. To learn more, visit http://www.publicconsultinggroup.com/health/.



Responsibilities

  • Oversees claims representatives and the entire claim process for all implemented agencies.
  • Ensures accurate reporting of claims processed, internal denial research results, and final remittance advice processing including discussion with internal management, client and/or public agency to ensure understanding of results.
  • Supervises staff that answer calls for project. Including mentoring and developing staff as well as provides ongoing feedback performance on an individual and on a team level.
  • Reviews and monitors claim, enrollment and call volumes and statistics.
  • Assists with new staff training and ongoing refresher training as needed.
  • Takes escalated calls.
  • Updates all relative tracking tools and reports.
  • Participates in audits and quality assurance functions.
  • Insures that assigned staff reach and maintain productivity and quality assurance goals.
  • Prepares and maintains department operating procedures and control documents.
  • Makes recommendations for process improvement to enhance performance.
  • Assesses staff knowledge, skills and abilities relative to claims, customer service and operations to continuously improve team performance.
  • Completes quarterly performance reviews.
  • Provides one on one meetings with each staff member on a monthly basis.
  • Maintains reports of Claims, Customer Service and Enrollment daily, weekly, monthly and quarterly KPIs.
  • Holds monthly team meeting.
  • Attends weekly meetings with clients.
  • Other duties as assigned.

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Qualifications

Education: High School Diploma or equivalent, Bachelor’s Degree Preferred

Experience: 1+ years’ experience supervising staff preferred; 2+ years relevant work experience in the healthcare industry



EEO Statement

Public Consulting Group is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, protected veteran status, or status as a qualified individual with a disability.  VEVRAA Federal Contractor.

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