Note: The job is a remote job and is open to candidates in USA. Imagine360 is a health plan solution company focused on self-funded healthcare and customized, member-focused health plan solutions. The Supervisor, No Surprise Act (NSA) Operations oversees a team handling provider negotiations, Independent Dispute Resolution, escalated cases, and operational issue resolution. The role also manages caseloads, develops team processes, coaches employees, and coordinates with providers, clients, third-party partners, and CMS.
Responsibilities
- Caseload Management
- Regular 1-on-1 meetings with direct reports
- Process review and improvement
- Remote meetings with third party partners and, occasionally, clients
- Train direct reports in accordance with department policies and procedures, and federal and state laws, to ensure successful NSA negotiations outcomes in IDR
- Respond to issues, questions, and concerns from management, providers, clients, other partners, and the team, to ensure a smooth member and provider experience
- Assist in hiring and training new candidates for the team
- Monitor employee productivity and provide constructive feedback and coaching
- Work escalated, high dollar, and otherwise high-priority cases
- Delegate special projects and cases as necessary
- Work with Manager to develop and support successful completion of goals for the team
- Maintain frequent communication with Manager to ensure efficient operations
- Manage escalated inquiries from both internal and external parties
- Develop and maintain department policies and procedures
- Identify enhancements and changes to workflows to increase effectiveness and productivity
- Manage and coordinate escalated issue resolutions with both internal and external parties
- Assist and manage voicemails and phone calls
Skills
- • College degree preferred but extensive experience without a degree would be considered
- • Minimum of 3 years of healthcare, health insurance, or customer service experience
- • Minimum 1 year of supervisory experience
- • Knowledge and understanding of CMS1500 and UB04 Medical Claim Forms, medical coding, and proficiency in Microsoft Office products desired
- • Bachelor's degree in business or healthcare administration preferred or related field
- • Experience with the No Surprises Act
- • Experience in billing, insurance, healthcare, or legal environments preferred
- • Demonstrated success in supervisory role
Benefits
- Multiple Health plan options
- Company paid employee premiums for disability and life insurance
- Parental Leave Policy
- 20 days PTO to start / 10 Paid Holidays
- Tuition reimbursement
- 401k Company contribution
- Company paid Short & Long term Disability plus Life Insurance
- Professional development initiatives / continuous learning opportunities
- Opportunities to participate in and support the company's diversity and inclusion initiatives
Company Overview