Claims Supervisor

Key Responsibilities

• Review and process medical claims in accordance with company policies and guidelines.
• Verify claim accuracy, reconcile provider accounts, and prepare payment transmittals.
• Approve claims within authority limits and escalate when necessary.
• Handle inquiries, disputes, and payment concerns within prescribed turnaround times.
• Coordinate with providers and internal teams on claims reconciliation and SOA validation.
• Support system enhancements through UAT testing and process improvement initiatives.

Qualifications

• Bachelor's degree in a medical, healthcare, or business-related field.
• Minimum 3 years of medical claims in a supervisory role.
• LOMA certification or coursework is an advantage.