Coordination of Benefits - Supervisor

 

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

 

This role ensures timely, accurate processing of all aspects of the identification, investigation, and validation processes for Coordination of Benefits (COB) and related eligibility products. The position monitors, prioritizes and distributes work to assigned team(s). The incumbent will work to facilitate quality processing of cases according to policy and procedures and client service level agreements (SLA's). This individual will work to identify recoveries for assigned clients that meet or exceed forecasts and partnering with senior leadership to execute on short and long term production strategies.

 

1. Schedules and prioritizes work, approve time off, conducts performance reviews, hires, and trains new employees, and performs other supervisory responsibilities and enforces production, quality, and customer-service standards / SLAs. Addresses issues with the team as a whole and individually.
2. Primary point of contact for offshore contractors, including but not limited to the following: hiring for correct skillset, work assignment, approving hours, coordinating training, mitigating vendor specific issues, and working with vendor management to drive acceptable results.
3. Partners with senior leadership to draft, develop, and implement policies, procedures, and strategies to improve department metrics and relevant KPIs.
4. Routinely utilizes expertise specific to coordination of benefits rules, regulations, methodologies, and audit tactics to ensure efficient day-to-day operation of the department.
5. Ensures compliance with CMS, NAIC and state COB guidelines. Ensures team is following company and client expectations.
6. Works closely with senior leadership to document policies, procedures, and processes. Maintains and improves COB/OHI processes by monitoring trends and addressing issues for process improvement.
7. Must maintain a high level of confidentiality in dealing with protected health information and ensure that teams do the same.
8. Fields client issues and complaints and decides on a course of action to resolve the matters.
9. Select, develop, and evaluate staff to ensure the efficient operation of department.
10. Collaborate, coordinate, and communicate across disciplines and departments.
11. Ensure compliance with HIPAA regulations and requirements.
12. Demonstrate Company's Core Competencies and values held within.
13. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

 

COMPENSATION

The salary range for this position is $65k-72k annually.  Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity.  This position is also eligible for health insurance, 401k and bonus opportunity.

 

This role works under limited supervision in the execution of the positions day-to-day responsibilities. This role will be a key contact in the drafting, implementation and maintenance of policies and procedures specific to the department. The incumbent will have a sizeable amount of influence on departmental revenue figures through the provision of effective mentorship of more junior team members. This is a people management job with authority for all HR actions (hiring, firing, discipline, training, etc.) as well as assign work and coordinate the work of offshore resources.