Claims Quality Audit Supervisor jobs in Sun Valley, NV

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary:  The Claims Supervisor will play a crucial role in ensuring the efficient and accurate processing of healthcare claims within our organization. You will lead a team of claims analysts, oversee claim submission, review, and adjudication processes, and collaborate with various stakeholders to maintain high-quality claims management practices. This role demands strong leadership skills, in-depth knowledge of healthcare billing and insurance procedures, and a commitment to delivering exceptional customer service.

Benefit Highlights:

• Loan Forgiveness Program 
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300 Subsidiaries! · More information is available on our Benefits Guest Website: benefits.uhsguest.com

Qualifications and Requirements:

• Associate’s degree in healthcare administration, business or related field or equivalent experience
• Minimum of 3 years in healthcare claims processing or a related role.
• In-depth knowledge of healthcare billing, coding, and insurance procedures.
• Strong understanding of healthcare regulations and compliance.
• Excellent English communication skills both verbal and written
• Experienced in meeting facilitation and conducting training sessions
• Possess strong interpersonal skills to work effectively with both internal and external customers
• Understanding of negotiations principles
• Proven ability to review and analyze statistical data identifying trends, problems or opportunities for quality service improvements.
• Proficiency in using claims management software and Microsoft Office (Excel, Word, Outlook, PowerPoint)
• Familiar with the budgeting process
• Strong organizational skills, work prioritization, follow up and attention to detail
• Self-directed and flexible in adapting to change
• Strong analytical and data interpretation abilities.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS

and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

If you would like to learn more about the opportunity, please contact Bridget Gomez at: bridget.gomez@uhsinc.com