The Claims Supervisor position is an essential role that is responsible for the management of the daily work flows, structure and leadership of the stop loss sector of the claims department. This position requires an experienced individual with strong management or supervisory skills, as well as a health care background, with the authority to ensure that the unit meets all quality, production and timeliness standards. In addition to the day-to-day supervision of the professional staff, this supervisor will work with both the Director of Operations and the Claims Production Supervisor for process improvement, strategic planning, decision making, and training. The supervisor must be able to assist the management team within the claims department in leading change and promoting a positive team attitude and be able to effectively respond to unexpected changes or demands. Please see below for a more in-depth overview of daily responsibilities and skills required for this position.
Skills required for this position:
- Minimum of 3-5 years’ experience as a Claims Supervisor.
- Must be able to maintain a positive work atmosphere by behaving and communicating in a manner so that you get along with peers, subordinates, customers, clients, and management.
- Strong claim knowledge/understanding as well as solid presentation, communication, facilitation, team building, conflict management and decision-making skills.
- Ability to achieve desired results while meeting customer needs.
- Must effectively deal with challenges and problems.
- Ability to communicate clearly (spoken and written communication).
- Must be a self-starter who is organized and able to handle multiple projects and due dates.
- Must have the ability to multi-task and prioritize projects throughout the day.
- Must possess leadership qualities and conduct oneself as an example for others.
- Must show confidence and good judgment in order to coach employees in all situations.
- Ability to work and interface with various levels of the organization.
- Must meet company standards for punctuality and attendance.
- Reviewing claim issues and handling various projects as assigned by the Claims Manager with accuracy and timeliness.
- Responding to questions posed by the Claim Analysts and other staff members needing assistance.
- Monitoring daily and weekly claim turnaround time.
- Monitoring production and audit statistics and meet with assigned staff on a monthly basis or more frequently, if necessary.
- Monitoring and identifying any benefit processing issues that require additional training and communicate to the Claims Manager. This includes updates to the Claims Manual/Guidelines on the PBA Web.
- Participating in the interview process of new staff.
- Mentoring new Claims Analysts.
- Coaching and developing employees.
- Writing and delivering employee reviews.
- Assisting with new group transitions.
- Responding to requests made by Department Managers as needed.
- Perform other duties as assigned to support PBA’s Mission, Vision and Core Values