Claims Clerk Supervisor - AI-Driven Adjudication Lead

Advanced Medical Management, Inc.; Long Beach (CA); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Employer-paid health coverage

Vision and dental premiums discount

FSAs and 401(k)

Generous PTO and holidays

Tuition reimbursement

Job summary

Advanced Medical Management, Inc. is seeking a Claims Clerk Supervisor to lead daily clerical and claims-support operations, guiding a team through intake, imaging, data entry, adjustments, correspondence, and appeals support.

You’ll work under the Manager of Claims Operations as a SME on reprocessing and procedures, ensuring quality and PHI protection. The role operates in a modern, largely paperless environment with AI-assisted tools, OCR/indexing, auto-adjudication, and anomaly flags, while

Qualifications

• High school diploma or GED required; associate’s degree or coursework in healthcare admin/business preferred.
• 4–6 years of healthcare claims processing/operations experience; 1–2 years in a lead/supervisory role.
• Strong knowledge of Medicare/Medicaid/commercial claims guidelines; managed-care experience preferred.

Responsibilities

• Supervise, train, and mentor claims clerks; act as SME on reprocessing and daily clerical procedures.
• Assign workloads, monitor productivity, and ensure accurate end-of-day close-out.
• Coordinate with claims managers, client services, vendors, and health plans to resolve claims issues.

Skills

Claims processing knowledge

Organizational skills

Microsoft 365

Clear communication

PHI & HIPAA compliance

Education

High school diploma or GED

Healthcare administration/related associate degree preferred

Tools

EZ-CAP

OnBase (Hyland)

SFTP/portals

RingCentral (fax)

EOB Writer

Job description

Advanced Medical Management, Inc. is seeking a Claims Clerk Supervisor to lead daily clerical and claims-support operations, guiding a team through intake, imaging, data entry, adjustments, correspondence, and appeals support.

You’ll work under the Manager of Claims Operations as a SME on reprocessing and procedures, ensuring quality and PHI protection. The role operates in a modern, largely paperless environment with AI-assisted tools, OCR/indexing, auto-adjudication, and anomaly flags, while