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We are seeking a detail-oriented and experienced Claims Quality Supervisor to lead our audit and quality assurance initiatives across all aspects of claims operations. This role is responsible for ensuring accuracy, efficiency, and compliance with contractual and regulatory requirements.
Key responsibilities include:
Developing and implementing internal quality assurance monitoring systems and reporting tools.
Overseeing audit programs to maintain high standards of compliance and performance.
Managing the customer service functions within the Claims Administration Department.
Leading and staffing the customer service team to meet established service goals and performance objectives.
Provide direct supervision and guidance for Quality Control and Customer Service staff and provide developmental and training opportunities for team members.
Salary Range: $78,500 - $163,600/Annually
Qualifications
Minimum of 5 years claims experience in a managed care environment required
Minimum of 2 years’ experience in supervising staff required
Must have comprehensive knowledge of claims processing and regulations.
Must have strong ability to problem solving skills. Ability to analyze problems and formulate plans, solutions and a course of action.
Ability to successfully execute many complex tasks simultaneously.
Ability to set own priorities and to work as a team member as well as independently.
Ability to perform comfortably in a fast paced, deadline-oriented work environment.
Proficient computer skills in Internet search capabilities, Microsoft Word, Excel, Access and Managed Care software (i.e. Diamond).
Thorough knowledge of health care industry, benefit plans, contracts and flow of related information.
Knowledge of professional and facility provider reimbursement/contracting methodologies.
Excellent interpersonal and verbal/written communication skills. Effective presentation skills.
Ability to maintain confidentiality of patient and business records.
At UCLA Health, you can help heal humankind, one patient at a time by improving health, alleviating suffering and delivering acts of kindness. As you do, you’ll achieve great things in your life and your career. We’re a world-class health organization with four hospitals consistently recognized among the nation’s very best as well as an internationally-renowned medical school, primary and specialty care clinics and much more. Within our dynamic, innovative and growing organization, you’ll find exceptional opportunities to make the most of your abilities in a supportive, empowering and inclusive environment. If you embrace our values of Integrity, Compassion, Respect, Teamwork, Excellence and Discovery we invite you to see all you can accomplish at UCLA Health.
