Claims Supervisor – Lead Claims Processing Team

About the role

Centivo is seeking a Claims Supervisor to lead a team of Claims Processors, ensuring accurate and efficient processing of employer‑sponsored health plan claims. The role sets productivity benchmarks, enforces quality standards, and drives continuous improvement.

Key responsibilities

• Oversee daily claims processing to meet service level agreements and quality metrics.
• Mentor and coach claims staff, develop performance plans, and provide constructive feedback.
• Generate reports on claim inventory, production, turnaround time, and quality for department leaders.
• Develop and monitor policies and procedures to ensure compliance with benefit plans and claim standards.
• Collaborate with Quality/Training, System Configuration, and support teams to manage backlog, standardize processes, and resolve system issues.
• Serve as liaison for projects, system implementations, and upgrades, including testing needs.

Required profile

• Minimum three years of experience with self‑funded health care plans in a TPA environment.
• At least three years supervising a claims team.
• Strong knowledge of insurance policies, claims handling, and legal requirements.
• Proven leadership, analytical, and communication skills.
• Experience with highly automated claim adjudication systems, preferably HealthRules Payer.

Required skills

• HealthRules Payer claim adjudication system.