Claims Medi-Cal Supervisor

To supervise the Medi-Cal Claims Specialists and Examiners, ensuring delivery of the highest level of customer service to the community and its medical providers.

Requirements

• Supervise the Medi-Cal claims specialists and examining staff
• Maintain claim inventories within established goals
• Interviews and participates in the selection of qualified candidates for the Medi-Cal claims specialist and examining positions
• Evaluates performance and provides developmental opportunities to staff
• Provides training of new staff as appropriate
• Counsels performance problems or issues when needed
• Reviews and signs time cards
• Reviews quality control audits with staff to ensure compliance within established department guidelines
• Identifies errors and deficiencies; develops and implements corrective action and training plans for staff
• Reviews department policies and procedures, recommends changes for more efficient operations
• Communicates changes and updates to staff when appropriate
• Monitors and maintains pended claims within established department guidelines
• Reviews and researches reasons for the lags related to pended claims
• Reviews and maintains Batch Error reports within established department guidelines
• Reviews Medi-Cal RAs weekly
• Prepares production statistics and related reports for the Manager’s/Director’s review
• Reviews and signs claim adjustments and high dollar claims within established guidelines

Benefits

• Paid Time Off
• 401k Matching