Claims Supervisor

• Effectively supervise 12-20 direct reports—consisting of claim examiners and claim team leaders, including remote employees
• Provide full-time technical support to Claims, internal departments, vendors, and customers.
• Distribute daily work to the team and monitor aging inventory resolution.
• Train new hires, vendors, and existing staff as needed.
• Research and respond to escalated issues and pertinent information on claims requiring adjudication.
• Review and process High Dollar claims and conduct quality reviews of claims and logic changes/updates.
• Assist Customer Service in resolving customer questions and concerns.
• Researching and resolving client inquiries and performing client-requested claim adjustments.
• Coach, counsel, and mentor employees to meet quality, claims accuracy, and productivity standards, and address performance and disciplinary issues.
• Conduct audits as needed and manage payroll, timesheets, employee schedules, and time off requests
• Perform quarterly Performance Evaluations and consistently host individual and team meetings with team members.

• 3+ years of experience in supervisory or leadership role.
• Advanced knowledge of Excel.
• Strong knowledge of contracts, medical terminology, and claims processing and procedures.
• 5+ years of advanced claims adjudication experience, including facility, professional, and ancillary claims.
• Excellent written and oral communication, interpersonal, and negotiation skills with the ability to prioritize tasks.
• Problem-solving and organizational skills, ability to prioritize and multitask effectively.
• Ability to establish and maintain positive work relationships with clients, coworkers, members, providers, and customers.
• Enthusiastic attitude, cooperative team player, adaptable to new or changing circumstances.
• Bachelor's Degree or comparable experience in the healthcare field preferred.

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