Supervisor of Claims Production
Company: Allied National, Inc
Location: Overland Park
Posted on: October 2, 2024
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Job Description:
Description:PURPOSE: The Supervisor of Claims Production is
responsible for the management and operation of the Claims Analyst
staff which includes production, quality review, personnel matters,
workflow, claims procedures and training. The Supervisor of Claims
Production will have a detailed understanding of the computer
system and working knowledge of the interaction of all functional
units in the claims department. This individual will be responsible
for the career growth, development and planning for future needs to
encompass the department as a whole and the individual claims staff
members. The primary focus is production, inventory management and
quality of the unit. ESSENTIAL FUNCTIONS: 40% 1. Management and
operation of the unit in accordance with company objectives and
guidelines as well as departmental guidelines and procedures,
including workflow, procedures and processes, training, quality
review and personnel matters: a. Plan, direct and maintain the
workload of staff. Coordinate staffing needs with Human Resources
and interview prospective employees referred by H/R. b. Develop and
maintain employee developmental plans, fostering an environment
which promotes growth and development. c. Establish and maintain
employee performance goals and minimum performance standards for
both production and quality. d. Complete employee evaluations
according to company guidelines. Discuss evaluation with employees
in a manner that motivates them to reach their potential for
maximum job performance. e. Counsel with individual employees
concerning performance, personnel issues, etc. and establish
corrective measures as necessary. Resolve and/or direct questions
or problems from staff members. f. Create and maintain job
descriptions for all staff members. g. Provide training as needed
for new and existing staff. 10% 2. Establish, implement, and
monitor all departmental guidelines and procedures. Oversee
maintenance of departmental guidelines and procedure manuals. 15%
3. Analyze department production/quality figures. Evaluate results
and communicate to staff on an individual basis to encourage their
growth and development. a. Evaluate, modify, or create new
production/quality standards and procedures on an on-going basis
and make recommendations to Claims Director. 5% 4. Consistently
identify improvements (systems and processes) to improve
performance and quality. 2% 5. Randomly audit files reviewed by the
Claims Auditors to determine appropriateness of the errors and to
review for consistency. 13% 6. Communicate with other members of
the Claims supervisory team to plan and direct the workflow
throughout the Claims Department and take action on situations that
arise between the different areas of Claims. 3% 7. Consult with the
Team Leads and other Claims Supervisors on the progress of trainees
throughout the training process. Assess progress and take
appropriate action. 2% 8. Respond to or direct staff to answer
situational questions from Customer Service Representatives via
Contact Management System. 2% 9. Resolve problem telephone calls
referred by upper management and respond accordingly. Refer files
to the Analysts to expedite actual processing or reprocessing. 2%
10. Provide assistance with managing any offsite office maintenance
and business transactions (Rockford). 2% 11. Organize and execute
schedule of onsite office meetings (Trimester) to include company
sponsored lunches/events.(Management retains the discretion to add
or change the functions of this position at any time.) MARGINAL
FUNCTIONS: 4% 1. Answer technical questions on claim files referred
by the Carrier or internal staff, or external questions by
insureds, agents, providers, etc., and periodically process problem
or complicated files. 2. Contact the Carrier by telephone or
written correspondence regarding specific claims or policy
interpretation as required. 3. Assist in case management functions.
Answer questions and review benefit reduction appeals and/or
denials as required. Communicate with vendors to establish referral
procedures and to resolve any questions or problems that arise. 4.
Review and evaluate employee suggestions. Encourage and develop
employee contributions in team problem solving and their ideas for
process improvements. 5. Prepare for and meet with external
auditors when necessary Requirements: 1. One year of experience in
a lead, quality or supervisory role. Insurance experience,
including claims processing, strongly preferred. 2. High school
graduate or equivalent. A college degree or college coursework is
preferred. 3. Demonstrated decision making abilities. 4. Ability to
speak English fluently. Ability to read, comprehend, follow, and
give written or verbal English instructions. 5. Excellent
interpersonal skills. Ability to listen and question employees to
determine level of understanding and/or define problems. Ability to
express self clearly in a courteous, confident, and consistent
manner. 6. Ability to compose proper business correspondence.
(i.e., letters, memos, and file documentation). 7. Excellent
telephone communication skills, (i.e., listening for understanding,
responding accurately and professionally). 8. Ability to perform
basic math skills. 9. Ability to operate in a ten-key calculator
and proficiency in using a personal computer, i.e., spreadsheets,
databases, reports, etc.10. Ability to meet company attendance
requirements and work extended hours as needed. 11. Ability to work
under and handle stress associated with varying workloads and
deadlines. 12. Ability to sit or stand for 7.5 hours a day. FACTORS
IMPORTANT TO SUCCESSFUL PERFORMANCE OF POSITION: Problem solving
Analytical ability Interpersonal skills Dexterity Communication
skills Coaching and mentoring Supervisory/Leadership The position
requires the ability to evaluate employee's performance and take
corrective or disciplinary action accurately, consistently, and
fairly. Excellent communication and interpersonal skills are needed
in verbal contact and written correspondence internally and with
those outside of the Company. Must have analytical and creative
abilities to solve problems and project future needs of the
department.PHYSICAL DEMANDS OF POSITION: Standing/Sitting 90% of
time Attend/conduct meetings, reviewing files. Walking 10% of time
Meetings, reference area and to monitor employees. Lifting/Carrying
20 lbs
NOTE: Applicants who need accommodation for an interview or job
testing, please request this in advance to the Human Resources
Department.
PI214ca62e389c-37248-35282713
Keywords: Allied National, Inc, Independence , Supervisor of Claims Production, Professions , Overland Park, Missouri
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