Medical Claims Supervisor

TL;DR

Medical Claims Supervisor (Healthcare): Oversee operational performance, client satisfaction, reporting oversight, and KPI ownership for assigned healthcare claims accounts with an accent on production, quality, turnaround time, and frontline leadership. Focus on driving remediation efforts, managing team leads and examiners, analyzing trends, and ensuring SLA compliance in a fast-paced environment.

Location: Remote within the United States (St. Louis, Missouri)

Company

Leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide, processing millions of claims annually with innovative workflow platform JetStream.

What you will do

• Oversee daily claims operations, own KPIs/SLAs, and drive accountability across team leads and staff for production, quality, attendance, and adherence.
• Monitor inventory, aging, turnaround times, and workflow; develop and execute remediation plans for gaps.
• Serve as key client contact, participate in weekly/monthly/quarterly reviews, and build relationships through proactive communication.
• Prepare and present operational reports using Excel, Power BI, and dashboards; analyze trends and risks.
• Ensure compliance with HIPAA/CMS, partner with QA on quality improvements, and drive process enhancements.
• Mentor and develop team leads/staff, conduct performance reviews, coaching, and support onboarding/training.

Requirements

• Minimum 3–5 years healthcare claims leadership experience with supervisory oversight of production teams.
• Strong experience in healthcare payer operations, claims workflows, client-facing operations, and KPI ownership.
• Strong reporting/data analysis with intermediate-advanced Excel; experience with systems like EZ-CAP, QNXT, Facets preferred.
• Strong leadership, accountability, organizational, and communication skills; experience managing remote/offshore teams preferred.

Nice to have

• Experience with client relationship management and operational implementations/transitions.
• Proficiency in reporting tools like Power BI and client systems.

Culture & Benefits

• Remote work with equipment provided and paid training.
• Comprehensive benefits: medical, dental, vision, life, HSA, 401(k).
• Paid time off (PTO) and 7 paid holidays.
• Supportive team focused on internal growth and professionalism.