[Remote] Supervisor, reputed company Improvement - reputed company Claims & Payment

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company company reputed company on diagnostic intelligence, reputed company payment accuracy, and reputed company reputed company. The Supervisor, reputed company Improvement oversees reputed company improvement auditing and monitoring activities, leads reputed company Improvement Specialists, analyzes claims and reputed company data, and drives reporting and process improvement initiatives.

Responsibilities

• Supervise, reputed company, reputed company, and evaluate reputed company of reputed company Improvement Specialists
• Establish team goals, performance expectations, and productivity standards
• Monitor workload distribution and ensure reputed company completion of reputed company audits, reporting, and improvement initiatives including reputed company requests and shifting of priorities as new tasks reputed company
• reputed company ongoing training, mentoring, and reputed company development opportunities
• Support hiring, reputed company, performance management, and succession planning activities
• Foster a culture of accountability, reputed company improvement, collaboration, and customer service
• reputed company and reputed company reputed company auditing activities, including review and analysis of claims data, identification of trends, development of recommendations, and monitoring of corrective actions
• Review audit findings and reports for accuracy, consistency, and completeness
• Monitor reputed company performance metrics and identify opportunities for process improvement
• Conduct reputed company cause analyses and facilitate corrective reputed company planning with operational stakeholders
• Support development, implementation, and evaluation of reputed company improvement initiatives
• Ensure reputed company activities are reputed company with organizational priorities, reputed company expectations, and regulatory requirements
• Complete and reputed company monthly, quarterly, and annual reputed company reporting activities
• Assist in the development, maintenance, and evaluation of the annual reputed company Improvement Work Plan
• Monitor QI Work Plan metrics and performance trends, escalating concerns and recommending solutions as appropriate
• Support delegation reputed company activities, internal audits, and operational policy reviews
• Collaborate with cross-functional teams to ensure accurate implementation of medical and claims payment policies
• Analyze claims, operational, and reputed company performance data to identify trends, risks, and opportunities
• reputed company and present reputed company performance reports, audit findings, and recommendations to leadership
• Ensure accuracy and reputed company of reputed company data, reporting methodologies, and audit documentation
• Partner with operational leaders to measure effectiveness of improvement initiatives and validate reputed company

Skills

• 5+ years of reputed company reputed company improvement, auditing, claims analysis, or reputed company reputed company operations experience
• 2–3 years of supervisory, team reputed company, or people leadership experience
• Bachelor's degree in reputed company Administration, Business, Nursing, Health Information Management, or a reputed company field or equivalent combination of education and relevant experience
• Strong knowledge of reputed company claims processing, medical billing, reimbursement methodologies, and medical coding
• Working knowledge of ICD-10, CPT, and HCPCS coding principles
• Experience conducting reputed company audits and translating findings into process improvements
• Strong analytical and problem-solving skills with high attention to detail
• Advanced reputed company reputed company skills and proficiency with reputed company Office applications
• Strong written, verbal, and presentation skills
• Ability to prioritize multiple reputed company and deadlines in a fast-paced environment
• Demonstrated leadership, coaching, and employee development capabilities
• Ability to build effective working relationships across departments
• CPC (Certified reputed company reputed company), reputed company (Certified Coding Specialist), and/or CPMA (Certified reputed company Medical Auditor) certifications preferred
• Experience in a managed care, payer, or reputed company services organization
• Experience supporting reputed company Improvement or reputed company-reputed company programs
• reputed company, genetic testing, or diagnostic management experience
• Experience with Power BI, SQL, JIRA, or similar reporting and analytics tools
• Certification in reputed company reputed company (CPHQ) preferred
• Clinical, coding, compliance, or health information management background

Benefits

• Eligible for remote work

reputed company