Senior Claims Team Lead - Self-Funded Health Plans (Remote)

Centivo; Buffalo (NY); Hybrid; USD 70,000 - 77,000; Full time

Job summary

Centivo, Buffalo, NY, seeks a Claims Supervisor to lead a team of Claims Processors, driving accurate and efficient processing for self-funded employer plans. You will set productivity benchmarks, enforce quality standards, and mentor staff to achieve performance goals.

You will develop policies, generate reports on inventory and metrics, and collaborate on system projects. A hybrid/remote setup from Buffalo is available with career growth opportunities.

Qualifications

• At least 3 years experience with self-funded health care plans in a TPA environment.
• At least 3 years supervising a claims team.
• Experience with an automated claim adjudication system.
• Experience with HealthRules Payer.
• Knowledge of health insurance benefit administration.

Responsibilities

• Lead a team of Claims Processors to ensure accurate and efficient processing.
• Set productivity benchmarks and enforce quality standards.
• Provide reports on claim inventory, production, turnaround lag, and quality metrics.
• Develop policies to ensure proper administration of client benefit plans.
• Mentor and coach staff to improve performance with feedback and training.
• Liaise on projects and testing needs for system implementations and upgrades.
• Establish annual goals and align them with organizational strategy.
• Foster morale and teamwork within the department.
• Perform other duties as deemed essential and necessary.

Skills

Leadership

Claims processing

Self-funded health plans

Team management

Quality & production metrics

Analytical skills

Tools

HealthRules Payer

Job description

Centivo, Buffalo, NY, seeks a Claims Supervisor to lead a team of Claims Processors, driving accurate and efficient processing for self-funded employer plans. You will set productivity benchmarks, enforce quality standards, and mentor staff to achieve performance goals.

You will develop policies, generate reports on inventory and metrics, and collaborate on system projects. A hybrid/remote setup from Buffalo is available with career growth opportunities.