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    Supervisor, Claims at Healthcare Partners in Torrance, CA

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    Description

    Supervisor, Claims
    Req: 14479
    Department: IMCS Claims
    Schedule: Full Time
    Shift: Days
    Hours: M-F 8AM-430PM
    Job Details: High School/GED
    1 - 3 years of experience required

    HEALTHCARE PARTNERS MEDICAL GROUP, a division of DaVita HealthCare Partners, Inc. (DVA: NYSE), is a top-rated Southern-California medical group and is widely recognized for its achievements in clinical excellence and patient satisfaction. Since 1992, HealthCare Partners has been committed to developing innovative models of healthcare delivery that improve patients' quality of life while containing healthcare costs. HealthCare Partners manages and operates medical groups and affiliated physician networks in Arizona, California, Nevada, Florida and New Mexico. As of Sept. 30, 2013, HealthCare Partners provides integrated care management for approximately 760,000 managed care patients. - Read More -



    We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.



    If you're looking to make a difference with a large, financially stable, well-recognized medical group, DaVita HealthCare Partners may be the employer for you.



    HealthCare Partners may be the employer for you. We are currently seeking aClaims Supervisor:

    Responsiblefor supervising the accurate and timely adjudication of claims and administers disposition according to contractual benefits and company procedures by providing direction and guidance regarding policies, procedures, workflows, and ensuring high quality customer service to regional and provider representatives.



    Required:

    *
    High school diploma, G.E.D. or equivalent. Includes special certification required for specific jobs.
    *
    Over 3 years and up to and including 5 years of experience in benefits and claims administration.
    *
    Computer literate.
    *
    Proficient in Microsoft applications (Word, Excel).
    *
    Extensive knowledge of all claim types.
    *
    Knowledge of managed care / HMO contracts and fee schedules.
    *
    Working knowledge of Medicare / HCFA regulatory requirements.
    *
    Working knowledge of ICD-9, CPT, HCPCS, RBRVS and RVS coding.
    *
    Ability to work with all levels of management.


    Preferred:

    *
    CRT experience.
    *
    3 to 5 years of recent managed care claims experience as a Claims Supervisor.
    *
    Significant experience in processing, adjusting and auditing all claims.

    HR Use Only: CB

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