Claims Service Supervisor- West Sacramento, CA (Hybrid)

Gainwell Technologies LLC•Any city, OH

9d•$60,000 - $82,044•Hybrid

About The Position

As a Claims Service Supervisor, you will be responsible for overseeing the day-to-day operations of healthcare claims processing team, ensuring claims are adjudicated accurately, efficiently, and in compliance with regulatory requirements, and client contracts. Providing leadership, coaching, quality oversight, and operational support to claims examiners and analysts while driving continuous process improvements and service excellence.

Requirements

3-5+ years of experience in healthcare operations or Medicaid-related functions.
5+ years of supervisory or people leadership experience.
Experience in one or more of the following areas: medical billing, claims adjudication, medical records or healthcare analytics.
Experience managing performance metrics, including KPIs, SLAs, productivity, and quality standards.
Excellent communication and interpersonal skills with the ability to engage effectively in a client-facing environment.
Ability to manage multiple priorities, meet deadlines, and operate effectively in a fast-paced, high-volume environment.
Strong proficiency in Microsoft Excel, including the ability to analyze data, reconcile information, identify discrepancies, and produce operational reports.

Responsibilities

Supervise and lead a team of healthcare claims examiners and analysts.
Monitor claim inventory, turnaround times, productivity, and quality metrices to ensure service level agreements (SLAs) are achieved.
Assumes supervisory responsibility of electronic and paper claims submissions; oversees analysis, correction and eligibility of edits and errors.
Analyze claim trends, denial patterns, and operational performance data to identify process improvement opportunities.
Develop and maintain standard operations procedures (SOPs) and training materials.
Lead, motivate, coach, and develop team members while addressing performance concerns and taking corrective action when necessary.
Conduct employee performance evaluations and development planning.
Promote best practices across all levels of the team to improve consistency, productivity, and quality.
Use Microsoft Excel to analyze operational data, reconcile information, identify trends, and prepare reports for leadership.
Monitor and report on team performance, including productivity, quality, inventory, and throughput metrics.
Identify workflow challenges, reporting discrepancies, and opportunities to improve team processes, accuracy, and efficiency.