Top 166 Senior field supervisor Jobs in Miami Dade County Fl

Healthcare Claims and Fee for Service Supervisor
Provider Network Solutions LLC —Miami, FL
- $63,000 - $65,000 a year
- Full-time
- 5 years
- HIPAA
- Bachelor's degree
Quick Apply
13d
Program Manager- Afterschool Program
GANG ALTERNATIVE INC —Homestead, FL
- $60,000 - $62,000 a year
- Full-time
- School experience
- Spanish
- Clean driving record
- 403(b) matching
- AD&D insurance
Quick Apply
Assistant Director of Solid Waste
City Of Homestead —Homestead, FL
- $120,850 - $157,105 a year
- Overtime
- Background check
- Clean driving record
- Microsoft Excel
Chief Admin Officer - Herbert Wertheim College of Medicine
Florida International University —Miami, FL
- $160,000 - $175,000 a year
- Online Application
- Background check
- 5 years
- Finance
1d
SVP, Content & Development
NBCUniversal —Miami, FL
- $300,000 - $340,000 a year
- Email
- Spanish
- 11+ years
- English
General Manager
Transdev —Miami, FL
- $76,000 - $95,000 a year
- Full-time
- Microsoft Word
- Background check
- Computer literacy
- Disability insurance
- Health insurance
5d
Manager of Operations - Maintenance
Miami Parking Authority —Miami, FL
- Full-time
- Carpentry
- Spanish
- Microsoft Excel
6d
AVP, Product Development & Operational Excellence
Royal Caribbean Group —Miami, FL
- Marketing
- Office
- Master's degree
Sr. Dir, Talent Strategy & Operations
Royal Caribbean Group —Miami, FL
- Microsoft Excel
- 11+ years
- Office
12d
Clinical Program Coordinator
University of Miami —Miami, FL
- Full-time
- Mid-level
- Ob/Gyn
- University
- Health insurance
- Dental insurance
6d
Senior Production Manager (IB)
KeHE Distributors, LLC —Hialeah, FL
- $100,000 - $130,000 a year
- Weekends as needed
- Spanish
- Customer service
- English
- Health savings account
- Paid holidays
Manager, Information Technology
University of Miami —Miami, FL
- Full-time
- Classroom
- 5 years
- University
- Health insurance
- Dental insurance
Sr Dir., Marine Transformation
Royal Caribbean Group —Miami, FL
- 11+ years
- Office
- Bachelor's degree
Sr Mgr, Program
Royal Caribbean Group —Miami, FL
- Microsoft Word
- 6 years
- Office
Manager, Strategy & Adoption
Royal Caribbean Group —Miami, FL
- Full-time
- Oracle
- 5 years
- Office
Mgr, Program
Royal Caribbean Group —Miami, FL
- Microsoft Word
- Bachelor's degree
- Travel
10d
Manager, Digital Workspace Support
University of Miami —Coral Gables, FL
- Full-time
- Hybrid work
- Google Workspace
- 5 years
- University
5d
Head of Commercial Partnerships
Concacaf —Miami, FL
- Email
- Spanish
- Microsoft Excel
- Up to 50% travel
Director, Design SLVR
Royal Caribbean Group —Miami, FL
- Microsoft Excel
- Microsoft Outlook
- 5 years
Senior Specialist, Broadcast & Media Operations
Royal Caribbean Group —Miami, FL
- Schematics
- Office
- Ability to lift 50 pounds

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senior field supervisor jobs near miami dade county fl

Healthcare Claims and Fee for Service Supervisor

Provider Network Solutions LLC -
Miami, FL

Quick Apply

Job Details

Full-time
$63,000 - $65,000 a year
13 days ago

Qualifications

X12 EDI
Healthcare dispute resolution
Staff supervision
Process audits
EDI
Medicare
Team supervision
Medicare coding guidelines
Payment processing
Standard Operating Procedures (SOPs) implementation
Insurance dispute resolution
Overseeing healthcare denial management
Coaching
CMS
Regulatory compliance in claims processing
AI tools proficiency
HIPAA
Performance management
Medical claims processing software
CMS regulatory compliance
Policy & process development
Health insurance knowledge
Medicare regulations
Decision making
System testing
Payment posting in medical billing systems
Technical writing
Interdisciplinary policy and procedure development experience
Insurance investigations
Centers for Medicare & Medicaid Services (CMS) billing regulations

Full Job Description

Description:

Position Summary

The Claims and Fee for Service Supervisor manages the operational activities and staff of the Claims and Revenue Cycle Department in accordance with the Company guidelines, client needs, and State and Federal requirements.

Duties and Responsibilities

Oversee and manage daily activities and functions of the Claims Examiners processing claims for services that are capitated and Fee for Service with the health plan.
Responsible for overseeing the Revenue Cycle Management and Claims department’s daily operations, including but not limited to, running daily/frequent reports to ensure claims are processed timely, accurately, and in compliance with all federal and state healthcare plan laws and regulations. As well as, posting of all 835 payments.
Develop, implement, and update Claims Policies and Procedures to ensure compliance with CMS, Medicaid, HIPPA regulations, and health plan requirements.
Report overpayments, underpayments, and other irregularities.
Manage and close out claims open tickets and provider claims disputes.
Ensure optimal handling of all claims, investigate claims issues, and provide claims training for all business units.
Work together with Provider Servicing and participate in provider education, as necessary.
Maintain a fully comprehensive understanding of the covered benefits, coding, and reimbursement policies and contracts.
Act as Subject Matter Expert in issues related to claims processing, payment dispute resolution, cost containment, audit processes, and contract interpretation.
Actively collaborate with management and staff to ensure that “best practices” are followed and continually seek efficient and innovative processes, technologies, and approaches to optimize the use of resources and enhance operations.
Conduct analysis around various claims payment processes to ensure accuracy of system configuration and provider payments.
Investigate and resolve problem claims, while focusing on improving errors and problems to prevent future occurrences.
Perform and execute various claims process testing requests to ensure desired results are met to support accurate claims payments.
Analyze and adjudicate complex claims when examiner is requesting Supervisor review.
Adjudicate claims by, including but not limited to, applying medical necessity guidelines, determining coverage and completing eligibility verification, identifying discrepancies and applying all cost containment measures when necessary.
Process medical claims by approving or denying documentation, calculating benefits due initiating a payment or denial letter when necessary.
Follow any center for Medicare and Medicaid (CMS) changes affecting claims processing.
Perform pre-payment audit and payment cycle.
Complies with performance standards as set forth by the department head.
Follow company policies, procedures, and guidelines to ensure legal compliance.
Update claims knowledge by participating in educational opportunities, whether system oriented or medical coding/terminology/interpretation.
Update and maintain departmental and specialty network standards of operating procedure (SOP).
Regularly meet with VP of Operations - to discuss and resolve reimbursement issues or billing obstacles.
Perform one-on-one meeting with the individual staff members.

Requirements:

Knowledge

Bachelor’s degree in health administration, Business, or a related field (or equivalent experience).
5+ years of experience in healthcare claims processing, Revenue Cycle Management, or medical billing; 2+ years in a supervisory or lead role preferred.
Strong understanding of CMS, Medicare, Medicaid, HIPAA, and healthcare compliance standards.
Proficiency with medical coding systems (ICD-10, CPT/HCPCS) and claims adjudication platforms.
Experience with payment posting, audits, dispute resolution, and claims system testing/UAT.
Experience using AI applications to streamline claims processing, improve accuracy in claim evaluations, and enhance decision-making efficiency.

Skills

Analytical & problem-solving skills to resolve complex claims, identify root causes, and ensure accurate payments.
Leadership & supervisory skills for managing daily operations, coaching staff, and conducting performance meetings.
Strong communication abilities to collaborate with providers, internal teams, and senior leadership.
Process & policy development skills, including writing SOPs, implementing best practices, and ensuring regulatory compliance.
Technical proficiency in claims platforms, RCM systems, Excel/reporting, and conducting system/UAT testing.

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Refine Your Search

senior field supervisor jobs in miami dade county fl

Healthcare Claims and Fee for Service Supervisor

Program Manager- Afterschool Program

Assistant Director of Solid Waste

Chief Admin Officer - Herbert Wertheim College of Medicine

SVP, Content & Development

General Manager

Manager of Operations - Maintenance

AVP, Product Development & Operational Excellence

Sr. Dir, Talent Strategy & Operations

Clinical Program Coordinator

Senior Production Manager (IB)

Manager, Information Technology

Sr Dir., Marine Transformation

Sr Mgr, Program

Manager, Strategy & Adoption

Mgr, Program

Manager, Digital Workspace Support

Head of Commercial Partnerships

Director, Design SLVR

Senior Specialist, Broadcast & Media Operations

I want to receive the latest job alert for senior field supervisor in miami dade county fl

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