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Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Workers' Compensation claims investigation and coordination, with strong leadership capabilities to mentor and develop team members. Proficient in managing operational metrics, ensuring compliance with HIPAA and other regulations, while maintaining high performance in a fast-paced environment.
Highest-signal resume keywords
Workers' Compensation Claims InvestigationLeadership and Team DevelopmentMicrosoft Office Suite ProficiencyMedical Billing and Insurance Claims ProcessingHIPAA Compliance
About the role
Key responsibilities & impact- Provide daily leadership, coaching, and support to team members
- Partner with the Manager to achieve departmental goals, operational objectives, and client expectations
- Supervise a team consisting of multiple job functions
- Serve as an advanced subject matter expert in Workers' Compensation claims investigation and coordination of insurance benefits
- Resolve complex or escalated accounts while maximizing reimbursement opportunities and ensuring timely account resolution
- Perform quality assurance reviews of claims, investigations, and follow-up activities
- Monitor productivity, quality, and performance metrics; provide coaching and corrective action
- Delegate work assignments and balance workloads
- Train, mentor, and support team members
- Lead departmental meetings and participate in leadership meetings
- Provide inventory updates, operational metrics, and team performance insights
- Review and distribute weekly status reports
- Identify workflow challenges and implement process improvements and best practices
- Address client concerns and assist with resolution efforts
- Maintain relationships with internal and external stakeholders
- Maintain confidentiality of Protected Health Information (PHI) and comply with HIPAA policies and regulations
- Participate in recruitment and interviews
- Perform additional duties and special projects as assigned
- Support compliance with HIPAA, GLBA, FCRA, and other applicable laws
Requirements
What you’ll need- High School Diploma or GED required
- One (1) year or more of previous supervisor or team leadership experience
- Minimum of three (3) years of related experience in Workers' Compensation, revenue cycle management, or a related healthcare reimbursement field
- Strong leadership and team development skills
- Excellent verbal and written communication skills with the ability to compose professional business correspondence
- Strong organizational, time management, and prioritization skills
- Exceptional attention to detail and accuracy
- Ability to effectively manage multiple priorities in a fast-paced environment
- Strong analytical, problem-solving, and critical thinking abilities
- Excellent interpersonal skills with demonstrated emotional intelligence and social awareness
- Ability to effectively coach, mentor, and motivate team members
- Proficiency in Microsoft Office Suite, including Microsoft Excel
- Knowledge of medical billing, insurance claims processing, and coordination of benefits, specifically Workers' Compensation
- Ability to maintain confidentiality and exercise sound judgment when handling sensitive information
- Ability to work independently with minimal supervision while maintaining a high level of performance
- Ability to meet established deadlines and productivity expectations
- Ability to adhere to an established in-office/on-site work schedule
- Demonstrated history of high performance and accountability
- Associate's or Bachelor's degree in Business, Healthcare Administration, or a related field preferred
- US remote-based colleagues are not permitted to work from a location outside of the United States without prior, written approval
Benefits
Comp & perks- Continuous growth and professional development support
- Training and mentorship opportunities
- Equal employment opportunity
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Workers' Compensation Claims InvestigationMedical BillingInsurance Claims ProcessingRevenue Cycle ManagementQuality Assurance ReviewsProcess ImprovementAnalytical Problem-SolvingPerformance Metrics MonitoringCoaching and MentoringTime Management
Soft Skills
LeadershipCommunicationInterpersonal SkillsAttention to DetailEmotional Intelligence
Certifications & Qualifications
High School Diploma or GEDAssociate's or Bachelor's Degree in Business or Healthcare Administration
Industry Keywords
HIPAAGLBAFCRAHealthcare ReimbursementProtected Health Information (PHI)