Job Description

The Claims operational teams are responsible for ensuring claims are processed accurately and adjudicated in accordance with member benefits, provider contracts, and organizational policies and procedures. The Claims Supervisor reports to the Senior Manager, Operations. As a Claims Supervisor, you will be responsible for the daily inventory of claims and assignment of work among claims examiners and the team’s contractors. You will also work closely with the Senior Manager, Operations in developing process improvements and collaborating with other units to ensure the Claims Department meets and/or exceeds performance standards.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• Manage a remote team while showcasing an understanding of basic supervisory/ management approaches such as work scheduling, prioritizing, coaching, performance management, and process execution.
• Foster a great place to work, communicating clear roles and responsibilities and building successful working relationships across the organization.
• Consult and make recommendations to management on operational issues to improve performance on operational challenges that result in a stronger customer experience and self-service capability. Develops new perspectives and approaches to solve existing challenges.
• Make decisions on people and operational matters consistent with the goals and objectives of a group
• Consistently achieve team performance metrics showcasing best in class service experience including but not limited to voice of the customer survey results, quality, and production.
• Assist in the development and maintenance of training documents.
• Organize the team workload and ensure claims inventory is appropriately assigned.
• Conduct analysis related to claims processing activities and determine root causes of claims suspensions and payment errors.

Your Knowledge and Experience

• Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree required
• 5 years of prior relevant experience required
• 2 years of experience operating in a lead role or equivalent leadership training or manager training required

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.