Claims Supervisor

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🔥 10 minutes ago

🌵 Arizona, New York, +2 more states – Remote

🌵 Arizona – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏰 Missouri – Remote

💵 $27 - $48 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

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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 that comply with state and federal regulations • Help to identify opportunities for improvements and resolve operational gaps/problems with a financial, regulatory, cost/benefit and stakeholder experience • Serve as a point of escalation for complex claims • Monitor claims quality reviews for accuracy, document results and identify trends and systemic root cause analysis • Prepare reporting, analysis and insights that is consistent with defined standards to drive operational excellence • Maintain appropriate records, files, documentation, etc.

🎯 Requirements

• 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

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules