Health Insurance Claims Supervisor

Job Description

The Claim Supervisor is responsible for the oversight and management of health claims processing and will have direct management of a team of claim examiners and/or support roles. The team is responsible for the accurate processing of health care claims on behalf of the employer plan and members benefits and will set and monitor claims examiner productivity goals and claim quality metrics.. Key to the success of this position includes: attention to detail, strong organizational skills and a good understanding of Microsoft Office tools

Role and Responsibilities:

• Managing Daily Team Operations - Managing team of up to 20 resources
• Team mentoring & coaching individual associates who may fall below desired performance
• Handle escalations on process issues that cannot be resolved by agents
• Monitoring and ensuring closure of daily/weekly and monthly deliverables - Managing SLA, Daily Reporting, Agent's leave planning
• Monitor random cases to improve quality, minimizing errors and track operative performance
• Assign tasks, supervise, mentor and complete timely performance evaluations.
• Conduct remote and side by side monitoring of member processing to ensure quality assurance standards are met.
• Consistently communicate changes such as policies, procedural and overall performance as a team and one-on-one.
• Ensure required training courses are completed timely.

Qualifications

• 4-5 years of Team Lead or Supervisory experience with 2/3 years' experience with claims processing
• Demonstrate strong work ethics by maintaining confidentiality of information.
• Requires specialized knowledge where problems, assignments and / or duties are difficult but related.
• Must be able to think and work independently, but structured by broad principles and / or procedures.
• High aptitude for working with numbers.
• Must work well under pressure and make decisions quickly
• Have excellent interpersonal and communication skills and ability to address conflict proactively
• High School Diploma or higher (will be verified and you will need to provide documentation during on-boarding process)
• Comfortable working from the Tampa office as required

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We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, caste, creed, religion, gender, marital status, age, ethnic and national origin, gender identity, gender expression, sexual orientation, political orientation, disability status, protected veteran status, or any other characteristic protected by law.

Wipro is committed to creating an accessible, supportive, and inclusive workplace. Reasonable accommodation will be provided to all applicants including persons with disabilities, throughout the recruitment and selection process. Accommodations must be communicated in advance of the application, where possible, and will be reviewed on an individual basis. Wipro provides equal opportunities to all and values diversity.