Supervisor, Claims

Location: San Francisco, CA, United States; full-time, 40 hours per week

Salary: $80,000 annually

Company

hirify.global is an independent third-party administrator in the United States, providing claims and benefits administration services through a nationwide office network.

What you will do

• Lead and supervise the Claims team, assigning work and monitoring quality, productivity, and accountability.
• Develop staff through performance management, goal setting, training, and employee relations.
• Maintain knowledge of assigned benefit plans and oversee claims processing for compliance and accuracy.
• Review and interpret new or updated benefit plans, test benefits, and create resource documentation.
• Provide technical review of large-dollar and complex claims, including benefit allowance and category validation.
• Investigate, evaluate, and report on third-party recovery cases involving stop-loss, accidents, medical malpractice, subrogation, and workers' compensation.

Requirements

• High school diploma or GED.
• Four years of experience processing complex health and welfare claims in a third-party administrator.
• One year of experience in a lead or supervisory role.
• Advanced knowledge of benefits claims adjudication, medical or dental terminology, ICD-10, and CPT-4 codes.
• Knowledge of claims operations, including claims payment, contract interpretation, and benefits communication.
• Strong communication, analytical, organizational, decision-making, problem-resolution, and Microsoft Office skills.

Nice to have

• Experience in a multi-employer or Taft-Hartley environment.

Culture & Benefits

• Health, vision, and dental coverage.
• 401(k) retirement savings plan with company match.
• Paid time off.
• Opportunities for professional growth.
• Reasonable disability accommodations are available in accordance with applicable law.