Senior Medical Claims Supervisor

Senior TLC; Gastonia (NC); On-site; USD 65,000 - 90,000; Full time

Job summary

Senior TLC in Gastonia, NC is seeking a Medical Claims Supervisor to lead the Medical Authorization team and ensure timely adjudication of claims. You will monitor queues, investigate discrepancies, and coordinate with Finance, Compliance and IT to optimize processing.

The role requires five years of experience in medical claims processing, with supervisory exposure and knowledge of CPT, ICD-10, HCPCS, and HIPAA. This is a full-time, exempt position reporting to the Director of Finance.

Qualifications

• Minimum five years of experience in medical claims processing, adjudication, or payer operations.
• Supervisory experience of 2–4 employees preferred.
• Working knowledge of health insurance operations, provider contracts, denials, and appeal processes.

Responsibilities

• Supervise the Medical Authorization team and processes.
• Monitor claims adjudication queues, pending inventories, suspended and denied claims.
• Investigate discrepancies, apply coding information and provider terms to resolve issues.
• Collaborate with operations, compliance, finance, quality, and IT to improve workflows.
• Prepare and submit monthly reports and assist with audits.

Skills

Medical claims processing

Team supervision

Claims adjudication

HIPAA compliance

Education

Bachelor's degree preferred

Associate degree in healthcare/administration

Tools

CPT

ICD-10

HCPCS

Job description

Senior TLC in Gastonia, NC is seeking a Medical Claims Supervisor to lead the Medical Authorization team and ensure timely adjudication of claims. You will monitor queues, investigate discrepancies, and coordinate with Finance, Compliance and IT to optimize processing.

The role requires five years of experience in medical claims processing, with supervisory exposure and knowledge of CPT, ICD-10, HCPCS, and HIPAA. This is a full-time, exempt position reporting to the Director of Finance.