Claims Supervisor, BahamaHealth

Application Deadline: 04 October, 2032Apply Now
Job Description

KEY ACCOUNTABILITIES:

 

  • Responsible for the general coordination of the day-to-day functions of the department.
  • Monitoring of the claims pre-logging process, assignment and distribution of claims for adjudication.
  • Processing of claims for Family Guardian employees.
  • Regular monitoring and analysis of adjudicator productivity ensuring output within expectations and identifying and addressing excess capacity opportunities and/or any unsatisfactory performance concerns.
  • Assists with the monitoring, reporting and resolution of pending inventory of outstanding claims & claims production levels.
  • Regular analysis of claims data to identify possible opportunities for product/process improvement.
  • Provide leadership and coaching to direct reports, ensuring adherence to Company policies & procedures and strict timelines for the submission of reports, etc.
  • Assist with any other functions assigned by management.

 

KNOWLEDGE & SKILLS:

 

  • Bachelor’s Degree or equivalent preferred;
  • Minimum 7 years’ experience in claims adjudication and/or claims auditing.
  • ACS,ARA,UND,PAHM,ALHC,FLHC,FLMI Designation or Equivalent
  • Certified Professional Coder (CPC) Designation
  • Knowledge of CPT AND ICD-9/10 coding, and claims adjudication rules and edits
  • Must be highly computer literate, especially with Microsoft Office suite of products.
  • Ability to communicate effectively, both orally and in writing
  • Must possess strong organizational and analytical skills with strong propensity for accuracy.
  • Ability to investigate and analyse information, and refer findings appropriately.
  • Must exhibit a high level of confidentiality.

Resumes with accompanying certificates should be forwarded via email to careers@familyguardian.com.

FamGuard thanks all applicants; however, only those short-listed will be contacted.

Functional Area:

BahamaHealth

Role:

Claims Supervisor, BahamaHealth

Employment Type:

Full Time