TriWest Healthcare Alliance

Supervisor, Claims Support

Recruiting Location Phoenix, AZ
ID 2020-3191

Overview

Position Located in Phoenix, AZ

 

Supervisor, Claims Support at TriWest Healthcare Alliance

 

Taking Care of Our Nation’s Veterans.

It’s Who We Are. It’s What We Do.

 

Do you have a passion for serving those who served?

 

Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!

 

Our job is to make sure that America’s heroes get connected to health care in the community.

 

At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.

 

Are you our next Supervisor, Claims Support?

Responsibilities

TriWest Supervisor, Claims Support:

 

This position is responsible for the day to day supervision of the staff that performs claims review, and/or resolution of claims issues for all types of claims.    In addition this position will be responsible for leading both focused and routine reviews, review and communication of high profile claims issues for specific veterans and providers, and reporting results of said functions, as well as other functions as necessary.   This position will be responsible for the day-to-day supervision of any external audits as well as for input to and adherence to the Claims Review annual plan.

 

  • Works with the other TriWest's departments on specialized claims reviews.
  • Assists in the development and implementation of department policies and training.
  • Makes recommendations for the audit plan.
  • Responsible for the daily supervision of staff which includes reviews, claims, correspondence, appeals, and enrollment situations that affect claims.
  • Prepares review sheets, quality review analyses, and corrective action plans of staff
  • Oversees resolution of issues brought to the various Claims committee meetings, and working with various TriWest and WPS departments to resolve issues.
  • In collaboration with Claims Management, provides updates to staff on process changes, point of contact changes, etc.
  • Provides telephone customer service assistance to Government employees, providers and veterans.
  • Collaborates with Director on workload, performance, or employee issues or concerns.
  • Recommend quality and productivity improvements to enhance service to all Veterans and providers.
  • Hires, evaluates and develops staff.
  • Oversees second and third reviews.
  • Perform other duties as assigned

Regular and reliable attendance is required.

Qualifications

Are you qualified?

  • Are you a Veteran, family member of a Veteran, a friend of a Veteran, or passionate about helping Veterans?
  • Do you have a High School diploma or GED?
  • Do you have 4+ years of experience with health care claims processing, billing, or other related functions?
  • Do you have Experience with interpretation of written policy, automated transactions, and communication of results of work items to appropriate management
  • Do you have experience as a Team lead, training or subject matter expert experience

 

Preferred:

  • Do you have Associate degree in related field?
  • Do you have Experience in a supervisor or leadership role?
  • Are you advanced in your Excel and Access skills?
  • Are you knowledgeable of Claims coding?
  • Are you knowledgeable of Claims Pricing?

 

 

More about Working at TriWest Healthcare Alliance

We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

  • Medical, dental and vision coverage
  • Generous paid time off
  • 401(k) Retirement Savings Plan (with matching)
  • Short-term and long-term disability, basic life, and accidental death and dismemberment insurance 

Equal Opportunity Employer

TriWest Healthcare Alliance is an equal employment opportunity employer. All qualified applicants are considered for employment, without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic made unlawful by applicable federal, state, or local laws.

 

Are you ready to make a difference in the lives of our nation’s heroes?

 

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