Claims Operations Supervisor (U.S. Healthcare Claims)

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    "description": "<p><span style=\"color: rgb(186, 55, 42); font-size: 18pt; font-weight: bold\">Claims Operations Supervisor (U.S. Healthcare Claims)</span><br></p>\n<p><br><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt\"><span style=\"font-weight: bold\">Work Set-Up: Office-based (Onsite)</span></span></p>\n<p><span style=\"color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt\"><span style=\"font-weight: bold\">Location:</span> Makati, Valero</span></p>\n<p><br><br></p>\n<p><span style=\"color: rgb(0, 0, 0)\">We are looking for a Claims Supervisor to lead U.S. healthcare claims operations, with a strong focus on team performance, quality, service levels, stakeholder communication, and continuous improvement. This role is ideal for a people leader with solid experience in healthcare claims, adjudication, or revenue cycle operations who can drive results in a fast-paced, metrics-driven environment.</span></p>\n<p><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-weight: bold\">Key Responsibilities</span></p>\n<ul>\n<li><span style=\"color: rgb(0, 0, 0)\">Lead daily claims operations to meet accuracy, productivity, quality, and service level goals.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Manage team performance through coaching, performance monitoring, and issue resolution.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Partner with training and QA teams to strengthen onboarding, refresher training, accuracy, and consistency.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Handle client or stakeholder communication, escalations, and operational updates in a timely and professional manner.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Provide regular business updates on team performance, quality, service levels, and improvement actions.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Drive continuous improvement initiatives to reduce errors, delays, and rework.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Ensure adherence to operational processes, controls, and compliance requirements.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Collaborate with cross-functional teams such as QA, training, workforce management, HR, and client services to support execution.</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-weight: bold\">Must-Have Qualifications</span></p>\n<ul>\n<li><span style=\"color: rgb(0, 0, 0)\">4+ years of experience in U.S. healthcare claims processing, adjudication, or revenue cycle management.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">2+ years of team leadership experience (20-30) Claim Examiners) in healthcare operations, claims, or revenue cycle management.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Strong understanding of claims workflows, medical terminology, coding concepts, benefits, and payer/provider processes.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Experience managing productivity, quality, service levels, and team performance in a metric-driven environment.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Ability to coach team members, manage escalations, and drive issue resolution.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Strong written and verbal communication skills for client, stakeholder, and internal operations discussions.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Strong analytical and problem-solving skills.</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-weight: bold\">Preferred Qualifications</span></p>\n<ul>\n<li><span style=\"color: rgb(0, 0, 0)\">Experience supporting U.S. health plans, TPAs, healthcare BPOs, or shared services operations.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Exposure to payment review, denials, appeals, or related claims functions.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Experience supporting training, onboarding, coaching, or capability-building initiatives.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Exposure to process improvement, automation, or digital transformation initiatives.</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Background in quality assurance, audit, or calibration activities.</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-weight: bold\">Work Setup</span></p>\n<p><span style=\"color: rgb(0, 0, 0)\">Office-based position</span></p>\n<p><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-weight: bold\">Key Competencies</span></p>\n<ul>\n<li><span style=\"color: rgb(0, 0, 0)\">Operational leadership</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">People coaching and performance management</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Quality and service level management</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Client and stakeholder communication</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Analytical thinking and problem-solving</span></li>\n<li><span style=\"color: rgb(0, 0, 0)\">Continuous improvement and cross-functional collaboration</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt; text-decoration: underline\"><span style=\"font-weight: bold\">COMPANY OVERVIEW:</span></span></p>\n<p><span style=\"color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt\">Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and</span></p>\n<p><span style=\"color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt\">satisfaction with plans’ members and providers. </span></p>\n<p><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt\">The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers.  The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually.  The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.</span></p>\n<p><br></p>\n<p><span style=\"color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt\">Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.</span></p>",
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