Medical Claims Supervisor

Why consider this job opportunity:

• Salary up to $98,750 annually
• Unique benefits package including alternative medicine coverage, generous PTO, and up to 16 weeks paid parental leave
• Opportunity for career advancement and meaningful mission-driven work
• Supportive and collaborative work environment with a focus on employee well-being
• Flexibility to adapt work schedules based on business needs

• Oversee, mentor, and evaluate claims examiners, ensuring performance management and KPI monitoring
• Lead claims processing and inventory management for timely and compliant claims adjudication
• Analyze quality review findings to identify and address root causes of errors in claims processing
• Act as the escalation point for complex claims, leading investigations and implementing corrective solutions
• Collaborate cross-functionally with internal departments to improve policies and procedures

• Strong understanding of medical terminology, CPT/ICD codes, and claims adjudication systems
• Demonstrated ability to motivate, train, and evaluate staff while achieving departmental goals
• Previous experience leading and managing claims examiners with a focus on process development
• Excellent written and verbal communication skills for team and external interactions
• Ability to manage multiple priorities and navigate ambiguity effectively

• Previous experience at a high-growth company
• Familiarity with state/federal healthcare laws and regulations
• Previous experience using Javelina
• Experience managing dynamic inventory
• Demonstrated success in leading special projects with impactful results