Claims Supervisor, Claims Review

Molina Healthcare Inc., is among the most experienced managed healthcare companies serving patients who have traditionally faced barriers to quality healthcare—including individuals covered under Medicaid, the Healthy Families Program, the State Children’s Health Insurance Program (SCHIP) and other government-sponsored health insurance programs. Molina has health plans in California, Indiana, Michigan, New Mexico, Utah and Washington as well as 21 primary care clinics located in Northern and Southern California with future plans in Ohio and Texas. The company’s corporate headquarters are in Long Beach, California.

Job Overview:

Under the general direction of the Claims Services Manager, this position is responsible for overseeing day-to-day workflows of the Claims Review unit. Be a liaison with internal departments to ensure accurate and prompt resolution of claims audits issues. Coach and Mentor employees, handle difficult claims, be an informational resource for employees, assist manager with personnel issues.

Job Requirements


~ Daily supervision and leadership of Claims Staff. Direct resources appropriately to ensure timely and accurate completion of audits.
~ Prepare and review performance evaluations. Counsel, train and assist employees. Interact with staff to build team interaction and promote departmental communication.
~ Ability to represent departmental interests at internal and external functions/meetings.
~ Lead special projects and audits as required.
~ Perform other duties as assigned.

- 5+ years experience in managed care inclusive of medical claims / encounters examining experience preferred.

- 2+ years claims recovery supervisory experience required.

- 3+ years of experience as a lead person in claims audit environment will be considered.


PREFERRED: Bachelor’s degree preferred.


Molina Healthcare offers competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE).