Supervisor, Claims Compliance; No Surprises Act

Position Summary

The Supervisor, Claims Compliance, (Supervisor, Allied Advocate) is responsible for assisting the Allied Advocate Management Team with the monitoring and management of the daily work and other functions within Allied’s cost containment department. Excellent organization, communication and planning skills are needed to create, support, and adapt workflows, processes and procedures that enable and encourage the team's optimum performance. The position will be responsible for building and sustaining long-term relationships, internally and externally, to facilitate work efforts, alignment, collaboration, and to strategize for future growth within the department.

• Mentor and develop employees through constructive and targeted 1:1 coaching and nurture an environment where they can excel through encouragement and empowerment; supply on-going support that paves the way for career growth.
• Monitor daily inventory reports to ensure all claims/calls are managed promptly and accurately.
• Develop and implement detailed workflows to improve the consistency and accuracy of the staff.
• Be aware of all behind the scenes processes such as call notes, tracking, and claim related functions.
• Coordinate with Client Service Team Members, and Account Managers to proactively identify escalations or impacts to clients.
• Coordinate with other departments Qic Link coding for Allied Advocate automation.
• Coordinate with reinsurance carriers as to all aspects of claim cost containment including monthly claim activity reports and contract extension requests.
• Fosters a sense of urgency and commitment to achieve goals resulting in the ability to influence the organization to meet and exceed client, member, and partner expectations.
• Maintain employee work schedules including assignments and training.
• Assist the Manager with coordinating current processes and workflows while working to find and improve internal processes with various Allied departments.
• Conduct regular meetings to ensure direct reports maintain service levels and meet assigned goals. Lead refresher training as needed.
• Work with other Allied Advocate Supervisors to distribute and adjust team resources as required.
• Create and distribute weekly Allied Advocate reports to Brokers and group contacts.
• Work to develop standard department metrics, audits, training guides, and best practices.
• Adhere to and apply all applicable privacy and security laws, including HIPAA (Health Insurance Portability and Accountability) and any regulations promulgated thereto.
• Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent.
• Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed.
• Actively engage, coach, counsel and provide timely, and constructive performance feedback.
• Performs other related duties as assigned.

• High School Diploma Required, College and Advanced Degrees Preferred.
• Continuing education in all areas affecting group health and welfare plans is required.

• Minimum of 3 years of in-depth knowledge of Medical Claims, Benefits, and administrative skills required.
• Intermediate level work experience with Microsoft Office, Word, Excel, Access, and Power Point software applications required.
• Ability to prioritize tasks and delegate them when appropriate.
• Ability to multi-task, this includes ability to understand multiple products, multiple levels of benefits within each product and work within multiple systems.
• The ability to easily learn other software and systems.
• Strong written and verbal skills.

• Accountability
• Communication
• Action Oriented
• Timely Decision Making
• Building Relationships/Shaping Culture
• Customer Focus

• This is a standard desk role – extended periods of sitting and working on a computer are required.

• Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100

Mbps download/25

Mbps upload. Reliable internet service is essential for staying connected and productive.

Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the…