Job Details

Overview

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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.

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.

Responsibilities

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.

Benefits

• 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

About Universal Health Services

One of the nations largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the Worlds Most Admired Companies by Fortune; and listed in Forbes ranking of Americas Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

• Associates 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.

Seniority level

• Not Applicable

Employment type

• Full-time

Job function

• Finance and Sales

Industries

• Hospitals and Health Care
• Mental Health Care

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