Claims Quality Supervisor

UCLA Health

Los Angeles, CA, USA
Base: $78,500 - $163,600 annually; bonus/equity: n...
On-site
5 years claims experience in managed care
2 years supervising staff experience
Knowledge of claims processing regulations
This role leads audit and quality assurance initiatives across all aspects of claims operations to ensure accuracy and compliance

Job Summary

  • This role leads audit and quality assurance initiatives across all aspects of claims operations to ensure accuracy and compliance.
  • The supervisor is responsible for managing customer service functions, staffing the team, and providing developmental guidance to staff members.
  • Candidates must possess comprehensive knowledge of healthcare industry benefit plans, contracts, and provider reimbursement methodologies.

Matching Summary

This role leads audit and quality assurance initiatives across all aspects of claims operations to ensure accuracy and compliance.

Salary

Base: $78,500 - $163,600 Annually; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • 5 years claims experience in managed care
  • 2 years supervising staff experience
  • Knowledge of claims processing regulations
  • Proficiency with Diamond managed care software
  • Strong problem-solving and analytical skills

Nice-to-have

  • Excellent interpersonal communication skills
  • Ability to work independently in fast-paced environment
  • Experience developing quality monitoring systems
  • Effective presentation skills for team training

Key Requirements

  • Minimum 5 years claims experience in managed care
  • Minimum 2 years supervisory experience required
  • Thorough knowledge of health care industry regulations
  • Proficient computer skills including Microsoft Excel and Access

Work Rights

Not specified

Tailored Resume

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