Claims Supervisor

Texas Children's Hospital • Bellaire, TX

7h

About The Position

The Claims Supervisor manages and directs a team of Claims Examiners and Claims Benefits Specialists. The role handles claims-processing concerns and issues that require strong knowledge, creativity, research, and communication with internal and external resources to achieve timely resolution.

The supervisor supports daily team operations, monitors productivity and accuracy, resolves escalated processing questions, and audits claims-related practices to ensure training and policy procedures are understood. The role also assists the Manager with performance reviews, team meetings, and process-improvement initiatives, reviews claims-payment reports and checks, and serves as the initial contact for work-schedule issues.

Requirements

• High school diploma or GED.
• Five years of claims-processing experience.

Responsibilities

• Proactively identify and resolve complex issues referred by Claims Examiners and Claims Benefits Specialists in a timely manner.
• Provide daily management support to Claims Examiners and Claims Benefits Specialists.
• Obtain and review daily production statistics for each team member with the Manager, and develop plans to improve production while maintaining accuracy.
• Respond rapidly and accurately to claims-processing questions through email or discussion, resolving questions daily to prevent pending claims or penalties.
• Monitor and audit specified criteria based on claims training to confirm understanding of policy and procedure guidelines; coordinate with the trainer or Manager to address comprehension gaps.
• Assist the Manager in conducting performance reviews and team meetings.
• Help the Manager identify process- and service-improvement opportunities and participate in developing and implementing action plans.
• Compile and review internal reports to identify incorrect claims payments across product lines for the weekly check run; complete the check review process and forward it for processing on the same day as the weekly check push.
• Serve as the initial point of contact for issues regarding work schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: High school or GED