Medical Claims Supervisor
Job Description
Job Description
We are looking for a Medical Claims Supervisor to lead a dynamic team in Winston-Salem, North Carolina. This role requires a skilled leader with a strong background in healthcare claims and a commitment to driving performance while maintaining a supportive team environment. The ideal candidate will bring both industry expertise and leadership experience to help the department achieve its goals. This is an onsite position.
Responsibilities:
• Oversee the daily operations of a team handling healthcare claims inquiries and adjudications.
• Monitor performance metrics, including KPIs, to ensure the department meets its objectives.
• Provide guidance and support to team members, fostering growth and accountability.
• Address escalated claims-related issues and ensure timely resolution.
• Collaborate with team leads to implement strategies that enhance efficiency and service quality.
• Develop and maintain workflows for processing claims and customer service inquiries.
• Train and onboard new hires, ensuring they understand company policies and procedures.
• Maintain a cohesive team environment, balancing empathy with performance-driven management.
• Evaluate and improve processes related to CRM systems to optimize customer interactions.
• Coordinate with upper management to align departmental goals with organizational priorities.
• Minimum of 3 years of leadership experience, preferably in healthcare claims or customer service.• Strong understanding of healthcare claims processing, including Medicare supplements and adjudication.
• Demonstrated ability to manage performance metrics and drive accountability within a team.
• Familiarity with CRM systems and customer service best practices.
• Proven track record of developing and implementing operational improvements.
• Exceptional communication and interpersonal skills to effectively lead and support a team.
• Ability to handle escalated issues with professionalism and resolve them promptly.
• Experience in onboarding and training staff to ensure consistent service standards.
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