Supervisor Claims - HNAS

Company :Highmark Inc.Job Description :JOB SUMMARYHNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve.This job supervises and coordinates the day to day activities of the various claims processing or claims adjustment units responding to internal inquiries or inquiries received by members, providers, or account representatives across all markets.ESSENTIAL RESPONSIBILITIESCommunicate effectively.Effectively supervise all assigned personnel.Coordinate any claim backlog distribution for regular and overtime work both interdepartmentally and companywide.Monitor and manage daily inventories to ensure adequate staffing and resources are available.Subject matter expert for benefit plan and claims processing issues, implementation of new groups and products, and transition meetings.Research quality issues and respond to error assessments.Ensure all business processes are routinely monitored. Recommend and design, if necessary, process improvements designed to improve accuracy, timeliness of process and/or eliminate manual effort.Other duties as assigned or requested.EDUCATIONRequiredHigh School Diploma or GEDSubstitutionsNonePreferredBachelor's degreeEXPERIENCERequired2 years experience in a claims environment1 year experience leading or supervising othersPreferredNoneLICENSES or CERTIFICATIONSRequiredNonePreferredNoneSKILLSKnowledge of multiple processing systems and workflowsKnowledge of claims processing methodologiesAbility to interpret all government regulations.Knowledge of Highmark products.Language (Other than English)NoneTravel Requirements0% - 25%PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONSPosition TypeOffice-basedTeaches / trains others regularlyOccasionallyTravel regularly from the office to various work sites or from site-to-siteRarelyWorks primarily out-of-the office selling products/services (sales employees)NeverPhysical work site requiredYesLifting: up to 10 poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to 50 poundsRarelyDisclaimer:The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.Compliance RequirementThis job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.Pay Range Minimum:$58,100.00Pay Range Maximum:$90,000.00Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.orgCalifornia Consumer Privacy Act Employees, Contractors, and Applicants NoticeReq ID: J275208