Claims Supervisor - Support
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Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota’s leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We’re an organization that’s going places. Be part of a team that cares about you, be part of UCare.
The Claims Supervisor - Support will perform support functions for the Claims Department including: sort and count incoming mail; scan claims into imaging system; file claims; retrieve claims; and, mail EOBs, EOPs and explanation letters. Train, monitor and coach the Claim Support staff. Document and provide timely performance feedback to employees and Leadership. Complete monthly reporting duties and actively participate in internal and external workgroups and implementation teams. Trigger DTR and NPD letters in the Amisys claims processing system in a timely manner. Process enrollment applications within 24 hours of receipt. Work with internal departments to ensure consistency and contunity of claim support functions. Specific duties and responsibilities include:
- Sort, prep, scan, process and audit annual enrollment forms with 24 hours of receipt. Develop timeframes for extracts with I/S, Enrollment and Sales. Create reports to compare current years enrollment to previous year.
- Trigger DTR and Medicare NDP letters in a timely manner and in accordance to DHS and CMS requirements and timeframes
- Sort incoming mail and faxes according to department-specified sort criteria for Centralized scanning.
- Scan claims in preparation for entry into the claim system. Re-scan claims that are unable to be entered and back-scan claims that were entered into the claim system directly from paper.
- File scanned claims and retrieve scanned/paper claims as needed for all UCare departments..
- Compile and prepare for mailing member letters, provider explanations of payment and other Claim Department correspondence.
- Responsible for cross departmental Implementation teams of new processes, software and products. Claims point person for implementation for Formworks. Assist the IS department with testing of upgrades for new or existing applications. Conduct testing, training and update procedures.
- Recruit, interview and select new staff. Train, monitor and coach employees including maintaining the daily schedules and workflows. Follow up with UCare departments and provider performance feedback in a timely manner.
- Develop and maintain Centralized scanning processes and procedures as needed
- Conduct team meetings with the assigned staff. Assist the Manager/Director with facilitation of department meetings including the development of the agenda, presentation of information and distribution of meeting minutes.
An Associates degree or Bachelors degree is preferred with course work in medical terminology, CPT-4 and ICD-9 coding required. Relevant work experience will be considered in lieu of a degree.
One to three years supervisory or leadership experience is required. One to three years of experience in an insurance environment is also required. CPT and ICD-9 coding, and medical terminology is necessary. PC or other computer system experience is preferred. Familiarity with medical claims is highly desired. Knowledge of Medicare and Medicaid products is helpful. Previous Amisys claim system and MACESS EXP experience is a plus.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You’ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis—just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.