Medical Claims Supervisor (Healthcare)

TL;DR

Medical Claims Supervisor (Healthcare): Oversee operational performance, client satisfaction, reporting, and frontline leadership of healthcare claims accounts with an accent on KPI ownership, remediation plans, and workflow management. Focus on driving team accountability, analyzing performance trends, and ensuring SLA compliance in a fast-paced environment.

Location: Remote (US)

Company

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

What you will do

• Oversee daily claims operations, monitor inventory, aging, and turnaround times across assigned accounts.
• Own account-level KPIs including productivity, quality, SLA compliance, and client escalations; develop remediation plans for gaps.
• Lead Team Leads and staff through performance reviews, coaching, corrective actions, and development.
• Serve as operational contact for clients, participate in weekly/monthly/quarterly reviews, and build relationships.
• Prepare and present operational reports using Excel, Power BI, and dashboards; analyze trends and risks.
• Ensure compliance with HIPAA, CMS, and client guidelines; drive process improvements and audit readiness.

Requirements

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

Nice to have

• Experience with client relationship management and operational implementations.

Culture & Benefits

• Remote work with equipment provided and paid training.
• Comprehensive US benefits: Medical, Dental, Vision, Life, HSA, 401(k).
• Paid Time Off (PTO) and 7 paid holidays.
• Supportive team focused on internal growth and development.