Healthcare Claims Operations Leader

Triple-S; Guaynabo (PR); On-site; USD 65,000 - 90,000; Full time

Job summary

Triple-S is seeking a Claims Supervisor to oversee claims processing operations in Puerto Rico. The role focuses on ensuring adherence to standards, policies, and regulatory guidelines while leading a team for efficient performance.

The ideal candidate will have a Bachelor’s degree and 3–5 years of experience in health insurance claims processing, with strong analytical and leadership skills to drive process improvements and compliance.

Qualifications

• Bachelor's degree in natural science, arts, or business administration.
• Three to five years of claims processing experience in health insurance.
• Experience in analysis, auditing or risk management preferred.

Responsibilities

• Supervise daily operations and monitor workflow.
• Train, mentor, and oversee staff.
• Monitor performance metrics and ensure timely outputs.
• Collaborate with teams to implement policy changes.
• Prepare productivity reports and presentations.
• Ensure compliance with regulations and company policies.
• Manage claims processing and escalations.
• Communicate trends to improve claims processing accuracy.

Skills

Financial & Business Acumen

Data Driven Insights

Customer Delight

One Company Mindset

Develops Talent

Practical Knowledge in Tech

Education

Bachelor's Degree in Natural Science or Arts

Job description

Triple-S is seeking a Claims Supervisor to oversee claims processing operations in Puerto Rico. The role focuses on ensuring adherence to standards, policies, and regulatory guidelines while leading a team for efficient performance.

The ideal candidate will have a Bachelor’s degree and 3–5 years of experience in health insurance claims processing, with strong analytical and leadership skills to drive process improvements and compliance.