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Supervisor, Medicare Claims Operations

Primary Location: Harrisburg, Pennsylvania
Additional Locations: PA-Harrisburg
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Description:
Responsible for the daily activities and supervision of a team of employees supporting the Medicare claims processing function.


Fundamental Components:
Develops, motivates, evaluates and coaches staff on work procedures, proper claim processing and teamwork delivering excellent customer service. Is visible and available to staff to answers questions, monitor production and quality and give ongoing feedback.
Utilizes available incentive programs to reward, recognize and celebrate team and individual successes.
Assesses individual and team performance on a regular basis and provide candid and timely feedback regarding developmental and training needs; includes completion of monthly and annual scorecards.
Establishes clear vision aligned with company values; motivates others to balance customer needs and business success.
Manages and monitors daily workflow and reporting to ensure business objectives are maintained and accurately reported; ensures resources are aligned appropriately across function and/or service center.
Develops and maintains strong collaborative relationships with constituents and internal business partners to maintain excellent lines of communication and share resources to meet common service center objectives.
Leverages the unit's resources to resolve plan, claim and call inquiries or problems by identifying the issue, obtaining applicable information, perform root cause analysis, and generate and act upon the solutions.
Remove barriers to job performance and ensures regulatory compliance.
Attracts, selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals. Builds a cohesive team that works well together.
Acts as liaison between staff and other areas, including management, all segments, provider teams, etc., communicating workflow results, ideas, and solutions.
Proactively analyzes constituent data, identifies trends and issues. Recognizes and acts on the needs to improve the development and delivery of products and services. Clearly identifies what must be accomplished for successful completion of business objectives.
Effectively applies and enforces Aetna HR policies and practices, i.e., FML/EML, Attendance, Code of Conduct, Disciplinary Guidelines. (*)

Background Experience:

3 - 5+ years’ experience in managing or participating in high volume transaction processing

Proven strong leadership skills as a performer/leader on a large team required.
Healthcare experience preferred.

Medical and/or dental claim experience preferred.



Additional Job Information:
Must be very focused, detail oriented and quality driven. Minimum production and quality standards are expected by your team and performance managed. Coaching and development is a primary responsibility.

Required Skills:
Leadership - Collaborating for Results, Leadership - Engaging and Developing People, Service - Providing Solutions to Constituent Needs

Desired Skills:
General Business - Communicating for Impact, Leadership - Driving Change, Service - Improving Constituent-Focused Processes

Functional Skills:
Claim - Payment management, Claim - Policies & procedures

Potential Telework Position:
No

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests

Click To Review Our Benefits (PDF)

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