Claims Supervisor

Department Name:

Claims Processing

Work Shift:

Day

Job Category:

Finance

Estimated Pay Range:

$26.82 - $40.22 / hour, based on location, education, & experience.

In accordance with State Pay Transparency Rules.

Banner Health was recently recognized on Forbes inaugural list of America’s Dream Employers 2025. This list highlights employers across the country that prioritize workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of their employees.

Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare. We offer diverse career opportunities, from entry-level to leadership positions, and extend our innovation to employment settings by including remote and hybrid opportunities.

As a Claims Supervisor, you will call upon your extensive claims processing history to lead a team of claims processors. You will assign ques, review audits with processors and auditors, and attend daily team meetings. You will manage timecards and payroll for your team. You will also ensure that contractual obligations for claims resolutions are met. This role does require five years of healthcare claims processing experience, knowledge of Medicaid Claims Processing and Policy, and a minimum of two years of experience working with the IDX Claims System.

Your work location will be entirely remote. Your work week will be Monday-Friday from 7:00 a.m.-4:00 p.m. in the Arizona Time Zone. If this role sounds like the one for you, Apply Today!

This is a fully remote position and available if you live in the following states only: AK, AL, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY. This position is fully remote with travel less than 15% of the time to either a Banner corporate or hospital site.  With this remote work, candidates must be self-motivated, possess moderate to strong tech skills and be able to meet daily and weekly productivity metrics.

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
The primary purpose of this position is to maintain day-to-day workflow in the Claims Department by timely processing of claims and special projects assigned to the Claims Department.

CORE FUNCTIONS
1. Supervises the claims processing and clerical staff including participating in hiring, development, appraisals, and disciplinary action when necessary.

2. Maintain workflow of Claims Department. Assures that the processing of medical and dental claims meets department production and accuracy standards and remains compliant with AHCCCS filing requirements. Assists with training and development of all Claims Department staff along with Claims Manager and Auditor/Trainer/Level IV processors. Represents Claims Department at meetings as assigned.

3. Manages the Pend Report and overall inventory. Assists processors in resolving aged pended claims. Review and release interface edits from ICES. With Claims Manager and other UAHP Department Managers, coordinates and prioritizes projects consistent with Health Plan needs.

4. Coordinates with UAHN, UMC and all network providers the payment of clams in a timely, efficient manner sharing responsibility for the education of these providers directly and through Network Development.

5. Review daily processor audits, with auditor/trainer, evaluating individual production and accuracy of each claims processor.

6. Provides back up for claims processors to maintain productivity standards and provider backup for processing of specialty claims such as transplants, hemophilia, and home infusion.

7. Perform research on questions regarding discrepancies, contract changes, and other issues impacting claims adjudication. Assist Appeals department and Claims Customer Care Leadership in resolving claims Inquiries.

8. Works closely with Finance, Information Systems and Provider Relations to ensure that effective work processes are maintained for accurate and timely payment of claims.

9. Works independently under limited supervision. Supervises within the function for the company. Has freedom to determine how to best accomplish functions within established procedures.


MINIMUM QUALIFICATIONS

Five years of claims processing experience, strong communication and organizational skills, and proficiency with mathematical concepts, including percentages, decimals, and fractions, and two years experience with IDX Claims System, as is the ability to proficiently use Microsoft Word and Excel including manipulating, analyzing, and researching data

Experience researching and resolving claims issues through projects and Provider meetings is required.

Ability to develop and maintain positive relationships and have the ability to communicate effectively and professionally with providers, other UAHN departments, and all staff.

PREFERRED QUALIFICATIONS

Strong knowledge of AHCCCS regulations, BA/BS preferred. Two years supervisory experience that includes experience in hiring, evaluating, and training employees preferred. CPC and CPC-H coding certification is also preferred

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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