Claims Verification Supervisor

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

📋 Description

• Oversee, mentor, and assess claims verification specialists.

• Organize workload allocation to ensure adherence to turnaround time standards.

• Direct the onboarding process and continuous training regarding claims procedures and compliance.

• Review completed claims to detect errors and potential training needs.

• Act as the escalation point for intricate or high-value claims.

• Uphold verification standards and internal controls to mitigate fraud, waste, and abuse.

• Monitor KPIs, including accuracy rates, turnaround times, denial rates, and productivity metrics.

• Recognize workflow inefficiencies and execute process enhancements.

• Communicate team performance and claim results to senior management.

• Ensure accuracy of documentation and adherence to regulatory standards.

• Remain updated on payer rule modifications and industry best practices.

• Collaborate with billing, underwriting, compliance, and legal teams.

⛳️ Requirements

• 3–5 years of experience in claims processing or verification.

• 1–2 years of supervisory or leadership experience in a claims or operations setting.

• Comprehensive understanding of claims adjudication, documentation standards, and regulatory compliance.

• Proficient in claims management systems and the Microsoft Office Suite.

• Analytical thinker with the capacity to convert data into actionable insights.

• Effective communicator; capable of presenting findings and suggestions to stakeholders.

• Bachelor’s degree in a relevant field preferred; equivalent experience will be considered.

🏝️ Benefits

• Medical, dental, and vision insurance.

• 401(k) plan with company matching.

• Health Savings Account (HSA).

• Life insurance coverage.

• Disability insurance.

• Paid time off.

• Parental leave.

• Fully remote work options.