Claims Supervisor
National Vision Administrators (NVA) · Clifton, NJ · 6 days ago
Project ManagementFull-time
Key Responsibilities
- Supervise claims staff and manage daily workflow
- Review and process complex and high-dollar claims
- Ensure accuracy of medical billing and coding (CPT, ICD-10, HCPCS, modifiers)
- Manage COB/TPL claims and resolve denials/rejections
- Ensure Prompt Pay compliance and regulatory adherence
- Oversee ManageEngine tickets and escalations
- Support audits, reporting, and quality assurance initiatives
- Train and develop team members
Qualifications
- 5+ years of Medicaid/Medicare claims processing and adjudication experience
- Strong knowledge of:CPT, ICD-10, HCPCS, modifiers
- CMS-1500 (HCFA 1500) forms and electronic billing
- Timely filing, resubmissions, appeals, and remittance advice
- Experience with COB/TPL and denied claims resolution
- Familiarity with AS400 or similar claims systems
- Strong Excel and Microsoft Office skills
- Excellent communication and organizational skills
- CPC, CPB, or CBC certification is preferred
- Prior experience in vision plans, optometry, ophthalmology, or eye care billing is preferred
Company Benefits
- Vacation and Sick/Personal Time
- Medical Insurance / Prescription / Vision / Dental
- Hearing Program Discount
- Short- & Long-Term Disability Insurance
- Life Insurance
- Flexible Spending Account
- 401(k) plus company match
- Employee Referral Program
- Employee Recognition
- Tuition Reimbursement
- Professional Development Training