Supv Collections

Job Summary

Supervise the day-to-day claim overpayment recovery operations and support a team responsible for maximizing recoveries through claim offsets, cash collections, wire transfers, and other electronic payment methods. This role works closely with internal business and technical partners to ensure the accurate management, recovery, allocation, and reporting of claim overpayment receivables while maintaining compliance with established financial controls and operational procedures.

The Supervisor is responsible for overseeing daily recovery activities, monitoring receivable inventories, managing payment allocation processes, and ensuring the timely resolution of outstanding claim overpayments across multiple claims and financial systems. This position provides leadership, coaching, and operational guidance to staff while supporting departmental goals, service levels, and recovery performance objectives.

Working collaboratively with Claims, Finance, Cash Application, Provider Customer Service, Compliance, and Technology teams, the Supervisor identifies operational challenges, supports process improvements, analyzes recovery trends, and helps implement solutions that improve efficiency, accuracy, and customer experience. Through strong team leadership, data-driven decision making, and a focus on continuous improvement, this role contributes to reducing aging receivables, strengthening financial controls, improving payment allocation accuracy, and enhancing recovery outcomes for providers, customers, and members.

The ideal candidate combines operational expertise, analytical skills, and people leadership to drive performance, ensure compliance, and support the ongoing success of the claim overpayment recovery function.

Responsibilities

·  Support the successful execution of departmental goals by fostering effective collaboration and communication among internal stakeholders involved in claim adjudication, overpayment recovery, and payment processing activities.

·  Supervise the daily operations of the claim overpayment recovery and payment allocation functions, ensuring accuracy, efficiency, timely recoveries, and adherence to established procedures.

·  Build and maintain strong working relationships with internal business partners and external stakeholders to support operational objectives, reporting needs, and process improvements.

·  Monitor operational workflows, identify issues and bottlenecks, and implement corrective actions to improve performance, productivity, and service levels.

·  Ensure compliance with internal financial controls, operational policies, and audit requirements to maintain the integrity of claims-related financial transactions and reporting.

·  Coach, develop, and support team members through ongoing performance management, training, mentoring, and professional development opportunities.

·  Analyze recovery trends, payment activity, and operational metrics to identify risks, opportunities, and areas requiring management attention.

·  Support compliance with applicable federal and state regulations, contractual obligations, and company policies related to claim overpayments, recoveries, claim adjustments, provider communications, and collection activities.

·  Partner with business and technology teams to support automation initiatives, system enhancements, testing activities, and the implementation of process improvements.

·  Prepare and communicate operational updates, performance metrics, project status reports, and key business insights to management and stakeholders.

·  Provide day-to-day leadership and guidance to recovery specialists and analysts, ensuring work is completed accurately, timely, and in accordance with departmental standards.

·  Collaborate with vendors and external business partners to resolve operational issues, improve recovery processes, and maximize collection opportunities.

·  Oversee recovery operations across multiple systems and platforms, ensuring consistent application of recovery policies and procedures.

·  Work closely with Claims, Finance, Cash Application, CFID, Provider Customer Service, and other operational areas to support effective management of claim receivables and recovery activities.

·  Monitor claim overpayment receivables throughout the recovery cycle and escalate issues as appropriate to maximize recovery outcomes and minimize aging balances.

·  Assign, review, and oversee the allocation, reconciliation, and application of high-volume recovery payments received through various payment channels and cash management systems.

·  Develop and distribute reports that provide visibility into payment allocation activities, recovery performance, inventory management, and operational results.

·  Recommend process improvements by evaluating current workflows, policies, procedures, and system functionality to enhance efficiency, accuracy, and service delivery.

·  Utilize data analysis, reporting tools, and operational metrics to support decision-making, workload management, and continuous improvement efforts.

·  Promote a culture of accountability, teamwork, customer service, compliance, and continuous improvement while recognizing and reinforcing strong performance.

·  Assist management with workforce planning, workload balancing, resource allocation, and the achievement of departmental performance goals and service-level commitments.