Claims Supervisor

🔥 13 hours ago

🗽 New York – Remote

🗽 New York – Remote

💵 $70k - $77k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 1%

What it means: how likely this posting is sitting open without active hiring.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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Centivo

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2017

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Centivo is an innovative health plan provider for self-funded employers that focuses on delivering high-quality healthcare at an affordable cost. The company believes in the power of primary care to improve health outcomes and reduce costs. Centivo offers plans with free primary care, no deductibles, and low, predictable copays, thereby encouraging members to utilize their health benefits without financial burden. The plans are curated to meet stringent price and quality standards, promoting a strong relationship with primary care providers and integrating virtual care options. Centivo's approach is designed to reduce overall medical expenses while enhancing the healthcare experience for both employers and employees.

📋 Description

• Lead a team of Claims Processors • Ensure accurate and efficient claims processing for employer-sponsored health plans • Set productivity benchmarks and enforce quality standards • Drive continuous improvement • Collaborate with support teams to manage backlog and turnaround times • Work with Quality/Training and System Configuration teams to standardize processes and resolve issues • Oversee appeals, subrogation, and overpayment/refunds as needed • Ensure claims are processed and paid according to benefit plans, pricing agreements, and required authorizations • Manage claims inventory against standard service level agreements • Educate and mentor claims staff • Establish performance plans and provide coaching and mentoring • Report claim inventory, production, turnaround lag, and quality metrics to department leaders • Develop and monitor policies and procedures for benefit plan and claims administration • Influence department morale, foster teamwork, and involve the team in solutions • Establish annual staff goals and provide performance feedback • Serve as claims liaison for projects, initiatives, testing, system implementations, and upgrades • Perform other essential duties

🎯 Requirements

• Thorough understanding of insurance policies, claims handling processes, and legal requirements associated with claims • Strong leadership and team management skills • Ability to analyze claims data and make informed decisions • Previous experience in claims processing or a related field, including supervisory experience • Understanding of health insurance benefit administration in a self-funded environment • Ability to read and understand various forms, documentation, files, and information • At least 3 years of experience with self-funded health care plans and processing in a TPA environment • At least 3 years of experience supervising a claims team • Prior experience with a highly automated and integrated claim adjudication system • Experience working with HealthRules Payer • Candidates must be authorized to work in the United States for any employer • Centivo does not sponsor work authorization visas

🏖️ Benefits

• Equity • Bonus • Ability to work from home • Remote work opportunity for candidates outside the Buffalo area