Supervisor-Fit Reimbursement

American Specialty Health Incorporated is seeking a Supervisor-Fitness Reimbursement to work with our Fitness Reimbursement (FNR) department. This position will supervise processing of fitness reimbursement requests by the Fitness Reimbursement team to ensure performance standards and client expectations are met.

Remote Worker Considerations

Candidates who are selected for this position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 50 Mbps upload speed).

Responsibilities

• Supervises Fitness Reimbursement processing activities and staff.
• Assigns and monitors daily work for Fitness Reimbursement Examiners to ensure processing deadlines are met.
• Works with Sr. Fitness Reimbursement Analyst on a daily basis to ensure processing timelines for pends are met.
• Ensures that proper training is completed, and ongoing meetings are conducted.
• Answers processing questions and offers guidance to Fitness Reimbursement staff as needed.
• Triages requests from other departments.
• Processes reimbursement requests with special handling requirements, or as needed.
• Facilitates monthly department meetings; prepares agenda and distributes minutes for those meetings.
• Reviews errors identified during Quality Review with the applicable Examiner for training and educational purposes.
• Keeps Manager informed on issues of urgency, priorities, identified barriers and provides feedback on work of direct reports.
• Documents team performance and provides ongoing feedback, coaching, development, and discipline.
• Maintains confidentiality of all member, provider, client and proprietary information.
• Assists in the preparation for health plan audits, including assembling support materials and copying of requests and reports.
• Participates in the hiring and termination process.
• Prepares and delivers performance evaluations.
• Prepares reports and assists with QI/QA, as necessary.
• Monitors production and turn-around time on a daily basis and notifies Manager of barriers and issues to achieving performance standards.
• Creates and/or monitors examiner production reports on a weekly basis and reports results to Leadership team.
• Monitors daily reports created to ensure all processes are complete and accurate
• Assists with user testing on new system programming or contract testing when applicable.

Qualifications

• High School diploma required.
• Minimum 2 years' experience with claims/reimbursement request processing, computers, 10 key, and typing.
• Knowledge of Microsoft Word, Excel and Access required.
• One year in supervisory capacity preferred.
• Knowledge of managed care operations preferred.
• Ability to recognize unique and/or problem situations and brings to attention of Supervisor.
• Demonstrated ability to meet department performance standards and support quality improvement processes.

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time.

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility or work from home. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth, related medical conditions, breastfeeding, and reproductive health decision-making), gender, gender identity, gender expression, race, color, religion (including religious dress and grooming practices), creed, national origin, citizenship, ancestry, physical or mental disability, legally-protected medical condition, marital status, age, sexual orientation, genetic information, military or veteran status, political affiliation, or any other basis protected by applicable local, federal or state law.

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.

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