Grow your career at APWU Health Plan

APWU Health Plan, a non-profit organization located in Elkridge, MD, is seeking a Claims Supervisor (Review & Recovery) to join our Claims Department.

The Review and Recovery Supervisor is responsible for managing the claims inventory and Review and Recovery staff through timely and accurate processing of higher level claims.  Additionally, managing the processing of claims adjustments through the correction of errors and handling of overpayments and underpayments. Managing reporting and working of reports pertinent to this unit in a timely and accurate manner.

RESPONSIBILITIES

• Meet given objectives pertaining to cycle time, QA and productivity.
• Operate within the unit administrative budget.
• Manage unit workflow and inventory.
• Respond to staff questions quickly and accurately.
• Maintain reporting of daily/monthly activities and goals of the unit.
• Update standards and write/update unit procedures on a timely basis and as needed.
• Administer Plan personnel policies/CBA accurately and equitably.
• Complete assignments in a timely manner.
• Initiate IT tickets for system issues.
• Respond to other departments’ inquiries timely.
• Manage all of the R&R reports in a timely manner and accurately report those results as needed on a given timeline.
• Ensure cross-training of staff on all ‘specialty’ claim types.
• Provide supplemental training to staff as needed.
• Participate and/or collaborate on assigned Health Plan projects, committees and meetings.
• Other duties as assigned.

REQUIREMENTS

• AA degree (or commensurate experience) preferred.
• Must have QNXT processing experience.
• Must have subrogation, Medicare, Medicaid and OIC/COB experience.
• Decision making/problem-solving skills.
• Motivational/leadership skills.
• Good verbal and written communication skills.
• 4+ years’ experience in a supervisory/work leader capacity.
• Extensive claims and claims adjustment knowledge.

We offer a competitive salary; health, dental, & vision insurance; 401(k); generous vacation leave; and tuition reimbursement. Please ensure all of the above requirements are clearly reflected in your resume or specifically addressed in your cover letter. Stated salary requirements (range is acceptable) are required for consideration. Experience in a Union environment preferred. No relocation assistance available. Must pass criminal records check and drug screening prior to employment.