Claims Operations Supervisor

American Benefit Plan Administrators, Inc.; San Francisco (CA); On-site; USD 74,000 - 91,000; Full time

Job summary

Zenith American Solutions seeks a Supervisor, Claims to lead a dedicated team of claims professionals in San Francisco. You will supervise workload, ensure accuracy, and optimize processes while maintaining regulatory compliance.

The role requires strong knowledge of health and welfare claims, contracts, and coding standards. You will mentor staff, manage performance, and collaborate with clients to implement and validate new plans.

Qualifications

• High school diploma or GED required.
• Four years of experience processing complex health and welfare claims in a TPA.
• One year of supervisory or lead experience.
• Strong knowledge of benefits adjudication, ICD-10 and CPT-4 terminology.

Responsibilities

• Provide daily leadership and supervision to claims staff; monitor quality and productivity.
• Distribute workload and ensure staffing aligns with client needs and regulatory requirements.
• Develop staff through performance management, goal setting, and training.
• Review new or updated benefit plans and validate accuracy of tests and payments.
• Lead technical review of complex or large-dollar claims; support subrogation and stop-loss activities.

Skills

Leadership

Communication

Analytical

Problem-solving

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Zenith American Solutions seeks a Supervisor, Claims to lead a dedicated team of claims professionals in San Francisco. You will supervise workload, ensure accuracy, and optimize processes while maintaining regulatory compliance.

The role requires strong knowledge of health and welfare claims, contracts, and coding standards. You will mentor staff, manage performance, and collaborate with clients to implement and validate new plans.