Professional Benefit Administrators leads with one guiding principle, provide exceptional benefit administration for self-funded health plans. Brokers who choose to partner with PBA will benefit from an ally who values cost containment, flexibility, responsiveness, member advocacy, transparency, and results. PBA collectively aligns through the organization’s core values of:
- Work together and respect each other,
- Be dedicated to the customer,
- Be accountable and do what you say,
- Take initiative, be willing to learn and strive for continuous improvement,
- Generate positive energy.
The Claims Production Supervisor (BlueCross BlueShield) position is an essential role that is responsible for the management of the daily workflows, structure and leadership of a claim team. This position requires an experienced individual with strong management or supervisory skills, as well as a BlueCross BlueShield claim processing background, with the authority to ensure that the unit meets all quality, production and timeliness standards.
Responsible for:
- LMA (lead, manage and hold accountable) a team of Claim Analysts
- Reviewing claim issues and handling various projects assigned by the Claims Manager with accuracy and timeliness.
- Responding to questions posed by the Claim Analysts and other staff members that may need assistance.
- Monitoring daily and weekly claim turnaround time to meet performance guarantees.
- Monitoring EDI 837 and 835 file frequency and accuracy.
- Monitoring production and auditing statistics.
- Monitoring and identifying any benefit processing issues that require additional training and communication with the Claims Production Manager.
- Participating in the interview process of new staff.
- Coaching, mentoring and developing team.
- Assisting with new group transitions.
- Processing claims as needed.
- Participate in client requested meetings when required.
- Perform other duties as assigned.
Skills required for this position:
- 5+ years BCBS claim processing experience
- 3+ years supervisory experience
- 3+ years’ experience with claims system (Javelina knowledge a plus)
- Must be able to maintain a positive work atmosphere
- Strong knowledge/understanding as well as solid team building, conflict management and decision-making skills.
- Ability to communicate clearly (spoken and written communication).
- Must be a self-starter who is organized and able to handle multiple projects and due dates.
- Must possess leadership qualities and conduct oneself as an example for others.
- Must show confidence and good judgment in order to coach employees in all situations.
- Ability to work and interface with various levels of the organization.
- Must meet company standards for punctuality and attendance.
Essential Functions Statement
- The person in this position must demonstrate strong attention to detail to be able to properly maintain various reports and documentation, and coordinate system setups and networks.
- The role is a remote role, dedicated space and high-speed internet required.
Objective
Benefits and Compensation:
- PBA offers a wide range of benefits including medical, dental, vision, life insurance, AD&D, critical illness, accidental illness, FSA, disability and 401k.
- Annual compensation for this role is $65,000-$85,000 based on prior experience (and meeting required skills)
Professional Benefit Administrators is an equal opportunity employer. In accordance with anti-discrimination law, this policy's purpose is to effectuate these principles and mandates. Professional Benefit Administrators affords equal employment opportunities to all employees and applicants and specifically prohibits any and all discrimination and harassment based on race, race-related traits, color, religion, national origin, ethnicity, ancestry, military status, sex, pregnancy, sexual orientation, gender identity, disability (mental or physical), age, marital status, citizenship status, unfavorable military discharge, genetic information, order of protection status, and any other protected status under federal, state, and local law. Professional Benefit Administrators conforms to the spirit as well as to the letter of all applicable laws and regulations.
Pay: $65,000.00 - $85,000.00 per year
Benefits:
- 401(k)
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Vision insurance
- Work from home
Work Location: Remote
