Claims Supervisor

Job Overview: The Insurance Claim Supervisor leads the daily operations of the insurance claims workflow, ensuring accurate claim submission, timely adjudication, and effective denial management. This role guides a team of claims specialists, collaborates with payers, and monitors performance to maximize clean claim rates, minimize denials, and optimize cash collections. Job Scope: The Insurance Claim Supervisor oversees the end-to-end lifecycle of insurance claims for the organization, including pre-billing validation, claim submission, payment posting, denial analysis, and appeal coordination. Working closely with the Revenue Cycle leadership, the supervisor standardizes claim workflows, enforces internal controls, and tracks key performance indicators to improve cash flow and reduce days in accounts receivable. This role provides day-to-day supervision to claims staff, coaches performance, and resolves complex payer issues, coordinating with Payer Relations, IT, Compliance, and Finance to implement system enhancements and ensure accurate reporting. The supervisor supports training, workload balancing, and staffing plans, and may manage relationships with outsourcing vendors or third-party billing partners. A strong focus on accuracy, compliance (HIPAA, CMS guidelines, payer contracts), and customer service is essential to deliver timely, accurate reimbursements and a positive patient financial experience. Job Requirements: Education and Experience: Educations and Certificates: • Bachelor’s degree in health administration, Finance, or related field preferred. Experience: • Minimum of 5 years of revenue cycle or claims processing experience in healthcare; prior supervisory or team-lead experience required. • Demonstrated success in reducing denial rates, improving clean claim submission, and accelerating payment posting. Skills and Professional Knowledge: • Strong people leadership and supervision skills; ability to coach and develop staff. • Proficiency in claims processing, denial management, appeals, and patient financial services. • Experience with EHR/Billing systems (e.g., Epic, MEDITECH, Oracle) and claim management software; familiarity with reporting tools and basic SQL/BI concepts is advantageous. • Excellent communication, negotiation, and problem-solving abilities with players and internal teams. • Solid understanding of regulatory requirements and internal controls. • Analytical mindset with the ability to translate data into actionable process improvements and to manage workload and performance metrics. Language: • Proficiency in written, read and spoken Arabic and English languages. Roles and Responsibilities (But not limited to): General Roles and Responsibilities: • Lead daily insurance claims operations to ensure timely submission and accurate adjudication. • Develop and enforce standardized claim workflows, policies, and internal controls. • Monitor and report on key metrics; drive improvements in denial management and cash flow. • Supervise claims staff; provide coaching, performance feedback, and professional development. • Collaborate with RCM leadership, Payer Relations, IT, Compliance, and Finance to resolve issues and optimize systems. Essential Functions / Responsibilities: • Oversee pre-billing validation, claims submission, payment posting, denial analysis, and appeals coordination. • Track metrics such as gross and net days in A/R, denial rate, clean claim rate, posting accuracy, and average days to resolution. • Conduct regular audits of claim submissions and denial reasons; implement corrective actions. • Manage payer communications, negotiate where appropriate, and escalate payer performance issues. • Lead process improvement initiatives to reduce denials and accelerate reimbursement. • Ensure integrity of EHR/billing system data, coding alignment, and security controls. • Provide training and supervision for frontline claims staff; manage workload and scheduling. • Prepare performance dashboards and variance analyses for leadership. • Maintain compliance with applicable laws, regulations, and internal policies. Show more Show less

Education and Experience: Bachelor’s degree in health administration, Finance, or related field preferred. Minimum of 5 years of revenue cycle or claims processing experience in healthcare; prior supervisory or team-lead experience required. Demonstrated success in reducing denial rates, improving clean claim submission, and accelerating payment posting.

Lead daily insurance claims operations to ensure timely submission and accurate adjudication. Develop and enforce standardized claim workflows, policies, and internal controls. Monitor and report on key metrics; drive improvements in denial management and cash flow. Supervise claims staff; provide coaching, performance feedback, and professional development. Collaborate with RCM leadership, Payer Relations, IT, Compliance, and Finance to resolve issues and optimize systems. Oversee pre-billing validation, claims submission, payment posting, denial analysis, and appeals coordination. Track metrics such as gross and net days in A/R, denial rate, clean claim rate, posting accuracy, and average days to resolution. Conduct regular audits of claim submissions and denial reasons; implement corrective actions. Manage payer communications, negotiate where appropriate, and escalate payer performance issues. Lead process improvement initiatives to reduce denials and accelerate reimbursement. Ensure integrity of EHR/billing system data, coding alignment, and security controls. Provide training and supervision for frontline claims staff; manage workload and scheduling. Prepare performance dashboards and variance analyses for leadership. Maintain compliance with applicable laws, regulations, and internal policies.