- Associate’s degree preferred; relevant professional experience in a health plan environment with an emphasis on billing, claims payment, coding or other closely related functions may be substituted
- Minimum of five (5) years of experience in health plans; managed care or PACE strongly preferred
- Experience in a claims processing environment with an emphasis on claims auditing
- Progressively responsible experience with demonstrated ability to mentor team members required
- Working knowledge in Medicare and Medicaid billing and guidelines, and the ability to understand and analyze contractual and regulatory requirements and their effect on claims payment and resolutions
- Experience leading in a data-driven organization, leveraging reports and data to prioritize and manage people and projects
- Comprehensive knowledge of claims processing and regulations, strong problem solving skills, and the ability to analyze problems and formulate solutions
We’re seeking a strategic, detail-oriented Claims Quality Assurance Supervisor who is passionate about claims accuracy, regulatory compliance, and continuous improvement. If you’re ready to join a team that values both its participants and team members, we’d love to hear from you!
Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications.