Claims Supervisor

🔥 1 minute ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $56.2k - $101k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Oversee the day-to-day work functions of the assigned claims area • Provide technical and leadership support to staff to resolve complex issues • Develop and implement policies and procedures compliant with state and federal regulations • Drive process improvement and cost control to process medical claims accurately and timely • Serve as liaison between internal customers, vendors and other claims lifecycle stakeholders • Ensure claims inventory is managed accurately, timely and within compliance requirements • Prioritize daily work volumes through reporting, load balancing and operational overtime management • Identify improvement opportunities and resolve operational gaps using financial, regulatory, cost/benefit and stakeholder-experience considerations • Review, investigate, adjust and resolve pending and complex claims; serve as escalation point • Monitor claims quality reviews, document results and identify trends and systemic root causes • Research, collect background information and documentation, and address issues across teams and departments • Prepare reporting, analysis and insights to drive operational excellence • Maintain records, files and documentation • Complete special projects and facilitate change • Perform other assigned duties and comply with policies and standards

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Associate degree in related field or equivalent experience required • 2+ years of health insurance industry, claims processing, physician’s office or other office services experience required • Previous experience in a supervisory/lead role with defined outcomes required • Experience with Medicaid, Marketplace and/or Medicare preferred • Ability to oversee claims inventory accurately, timely and within internal and regulatory requirements • Knowledge of state and federal regulations • Experience with reporting, analysis and insights • Experience reviewing, investigating, adjusting, and resolving claims, especially complex claims

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plan • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity

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