Supervisor, Claims

Centene Corporation•Remote-IL, IL

16h•$56,200 - $101,000•Remote

About The Position

The Supervisor, Claims oversees the day-to-day work of an assigned claims area and provides technical and leadership support to staff resolving complex issues. This role develops and implements policies and procedures that comply with state and federal regulations, supports process improvement and cost control, and helps ensure medical claims are processed accurately and timely. The Supervisor also serves as a liaison among internal customers, vendors, and other stakeholders in the claims life cycle. Applicants may work remotely from home anywhere in the United States. Applicants must be authorized to work in the U.S. without current or future employment-based visa sponsorship. The position requires an associate degree in a related field or equivalent experience, at least two years of relevant health insurance, claims processing, physician’s office, or other office services experience, and prior supervisory or lead experience with defined outcomes. Experience with Medicaid, Marketplace, and/or Medicare is preferred. The stated pay range is $56,200 to $101,000 per year.

Requirements

Associate degree in a related field or equivalent experience.
At least 2 years of experience in the health insurance industry, claims processing, a physician’s office, or other office services.
Previous supervisory or lead experience with defined outcomes.
Authorization to work in the U.S. without current or future employment-based visa sponsorship.

Nice To Haves

Experience with Medicaid, Marketplace, and/or Medicare.

Responsibilities

Oversee and support claims inventory management to ensure accuracy, timeliness, and compliance with internal and regulatory requirements.
Prioritize daily work volumes using reporting and load balancing, and manage operational overtime costs.
Identify improvement opportunities and resolve operational gaps and problems, considering financial, regulatory, cost-benefit, and stakeholder-experience factors.
Assist in reviewing, investigating, adjusting, and resolving pending claims, particularly complex claims, and serve as an escalation point.
Monitor claims quality reviews, document results, and identify trends and systemic root causes.
Serve as a point of contact for the team, plan, and other departments to research and collect background information and documentation and address issues.
Prepare reporting, analysis, and insights in line with defined standards to drive operational excellence; maintain appropriate records, files, and documentation.
Perform special project work as assigned.
Facilitate change to support current and future business needs.
Perform other duties as assigned and comply with all policies and standards.