Claims Supervisor

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the Claims team, managing claims processing workflows, queue management, and daily operational tasks.

• Coordinate workflows and spearhead initiatives aimed at reducing errors.

• Assist staff with claim payment protocols while providing supervision and performance feedback.

• Conduct annual performance evaluations and set goals for team members under your supervision.

• Ensure claims are processed correctly and within designated contractual and regulatory timelines.

• Oversee claims inventory and suggest enhancements.

• Train, orient, mentor, and delegate tasks to team members.

• Address aged claims and support projects related to claims adjustments.

• Present updates and topics related to claims processing during team meetings.

• Develop and execute plans for operational improvements.

• Test system modifications to ensure accurate processing and outcomes.

• Assist with both internal and external audit activities.

• Maintain departmental workflows and standard operating procedures.

• Communicate with internal stakeholders regarding pending or open items.

• Act as an escalation point and primary technical contact for claims processing challenges.

• Investigate root causes, troubleshoot issues, and perform problem-solving tasks.

• Create, maintain, and distribute weekly, monthly, and quarterly reports on inventory and production.

• Lead huddles and meetings for the Claims Team.

• Provide assistance with special projects and other responsibilities as assigned.

⛳️ Requirements

• High School Diploma or GED is required.

• A minimum of 3 years of experience in claims processing is necessary.

• At least 2 years of previous supervisory or leadership experience is required.

• Familiarity with Medicare, Medicaid, and/or Commercial insurance terminology, as well as advanced claims payment processes.

• Intermediate proficiency in Microsoft Office applications, including Excel, Word, Adobe, and other Windows-based tools for data aggregation, analysis, trending, and reporting.

• Flexibility to work varied hours to meet business needs across all time zones.

• Maintain sufficient internet service to perform essential remote job functions; a minimum of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN is required.

• Knowledge of CPT, HCPC, dental, and diagnosis coding.

• Understanding of general claims processing principles.

• Ability to prioritize competing tasks and meet tight deadlines.

• Strong attention to detail and accuracy.

• Excellent organizational skills with the ability to manage multiple responsibilities and adhere to deadlines.

🏝️ Benefits

• Competitive compensation package.

• Medical, dental, supplemental health, life, and vision insurance for you and your dependents with no waiting period.

• Life and disability insurance coverage.

• 401(k) plan with company matching.

• Tuition assistance program.

• Paid parental leave benefits.

• Backup family care options.

• Flexible time-off policy.

• Flexible dress code and work location policies.

• Access to Employee Resource Groups.

• Opportunities for social responsibility and community volunteering.