Remote Claims Supervisor for Self-Funded Plans

Centivo; South Dakota; Hybrid; USD 90,000 - 140,000; Full time

Job summary

Centivo seeks a Claims Supervisor to lead a team of Claims Processors for employer-sponsored health plans. You will set productivity benchmarks, enforce quality standards, and drive continuous improvement while coordinating with Quality/Training and System Configuration teams to standardize processes.

You will oversee appeals, subrogation, and overpayments/refunds, ensuring compliance and efficiency, with remote/hybrid work options and a Buffalo-area alignment for onsite collaboration.

Qualifications

• Knowledge of health insurance policies, claims handling processes, and related legal requirements.
• Strong leadership and team management skills to drive performance.
• Ability to analyze claims data and make data-driven decisions.
• Prior supervisory experience in claims processing or a related field.
• Understanding of self-funded health plan administration.
• Ability to read and interpret various forms and documentation.

Responsibilities

• Lead a team of Claims Processors and set productivity benchmarks.
• Ensure claims are processed and paid per benefit plans and authorizations.
• Manage backlog and monitor SLA adherence with cross-functional teams.
• Mentor staff to achieve quality and production targets with coaching.
• Provide reports on inventory, production, turnaround time, and quality metrics.
• Develop policies to administer benefit plans and claim standards.

Skills

Leadership

Claims processing

Self-funded plans

Quality metrics

Team management

Documentation reading

Tools

HealthRules Payer

Job description

Centivo seeks a Claims Supervisor to lead a team of Claims Processors for employer-sponsored health plans. You will set productivity benchmarks, enforce quality standards, and drive continuous improvement while coordinating with Quality/Training and System Configuration teams to standardize processes.

You will oversee appeals, subrogation, and overpayments/refunds, ensuring compliance and efficiency, with remote/hybrid work options and a Buffalo-area alignment for onsite collaboration.