Remote Claims Supervisor: Lead & Improve Processing

Centivo; United States; Hybrid; USD 85,000 - 120,000; Full time

Job summary

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

You will oversee appeals, subrogation, and refunds, ensure compliance, and manage SLAs, with a focus on coaching staff and achieving optimal production and accuracy.

Qualifications

• Thorough understanding of insurance policies, claims handling processes and legal requirements.
• Strong leadership and team management skills with the ability to motivate a team.
• Ability to analyze claims data and make informed decisions.
• Experience supervising a claims team.
• Experience with self-funded health care plans.
• Ability to read and understand various forms and documentation.

Responsibilities

• Lead a team of Claims Processors to ensure accurate and efficient processing.
• Set productivity benchmarks and enforce quality standards.
• Manage backlog and SLA adherence across the team.
• Mentor staff and develop performance plans for underperformers.
• Provide reports on inventory, production, turnaround lag and quality metrics.
• Develop policies to ensure proper administration of benefit plans and claims.

Skills

Insurance knowledge

Leadership

Analytical skills

Supervisory experience

Self-funded health care

Documentation comprehension

Tools

HealthRules Payer

Job description

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

You will oversee appeals, subrogation, and refunds, ensure compliance, and manage SLAs, with a focus on coaching staff and achieving optimal production and accuracy.