Healthcare Claims Operations Supervisor (Healthcare)

TL;DR

Healthcare Claims Operations Supervisor (Healthcare): Managing operational performance, client satisfaction, and KPI achievement for healthcare claims accounts with an accent on claims adjudication and leadership of production teams. Focus on driving SLA compliance, analyzing operational metrics via Power BI/Excel, and ensuring adherence to HIPAA and CMS guidelines.

Location: Remote (US)

Company

hirify.global is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide.

What you will do

• Oversee daily claims operations and ensure achievement of all client KPIs, SLAs, and quality standards.
• Monitor productivity, inventory aging, turnaround times, and workflow distribution.
• Serve as the primary operational contact for clients, managing business reviews and escalations.
• Analyze performance trends using Excel and Power BI to deliver accurate reporting to leadership and clients.
• Ensure strict compliance with HIPAA regulations, CMS guidelines, and company policies.
• Coach, mentor, and develop Team Leads and Claims Examiners to foster a culture of accountability.

Requirements

• 3–5 years of healthcare claims leadership experience.
• Prior supervisory experience overseeing production teams.
• Strong expertise in healthcare payer operations and claims workflows.
• Intermediate to advanced Excel and data analysis experience.
• Must be based in the US to align with provided benefits (401k, HSA).
• Experience with systems such as EZ-CAP, QNXT, Facets, Jiva, or Plexis is preferred.

Nice to have

• Experience managing offshore and/or remote teams.

Culture & Benefits

• Remote work arrangement with equipment provided.
• Comprehensive health benefits: Medical, Dental, Vision, and Life insurance.
• Financial perks including HSA and 401(k) plan.
• Paid Time Off (PTO) and 7 paid holidays.
• Paid training and a corporate culture that values internal growth.