Job Overview (Part Time/Full Time available)
We are seeking an experienced Claims Supervisor specializing in dental insurance to join our team. In this on-site role, you will leverage your expertise in insurance and dental claims adjudication to ensure accurate and timely processing of dental claims. You will initially work closely with our current claims team to learn our processes and procedures. As you become proficient, you will transition to managing the team, applying your skills in claims analysis and problem-solving. This position is critical to maintaining our high standards of claims accuracy, customer satisfaction, and compliance with policy guidelines.
Key Responsibilities
- Supervise the daily operations of the claims department to ensure timely and accurate claims processing.
- Monitor individual and team productivity, quality, and turnaround times against department service level goals.
- Review and approve complex or escalated claims while ensuring adherence to plan documents and company policies.
- Coach, train, and develop claims staff through regular feedback, performance evaluations, and ongoing education.
- Conduct quality assurance audits and implement corrective actions to improve accuracy and consistency.
- Investigate and resolve escalated provider, member, employer, and broker claim issues.
- Ensure compliance with all applicable regulations, contractual requirements, and internal procedures.
- Identify process improvement opportunities and implement workflow enhancements to increase efficiency.
- Collaborate with Customer Service, Provider Management, IT, Enrollment, and Finance to resolve cross-functional issues.
- Monitor claims inventory and workload distribution to maintain service standards.
- Assist with testing and implementation of system enhancements, claim edits, and new plan configurations.
- Develop and maintain department policies, procedures, and training documentation.
Qualifications & Skills
- Previous supervisory or team lead experience preferred.
- Knowledge of dental insurance claims adjudication, benefit interpretation, and provider reimbursement methodologies.
- Proven ability to lead, coach, and develop employees in a fast-paced environment.
- Strong analytical and problem-solving skills with exceptional attention to detail.
- Excellent written and verbal communication skills.
- Strong organizational skills with the ability to work independently and collaboratively across departments.
Work Environment
- On-Site Position: This role is based at our office and requires on-site attendance during business hours. The on-site environment fosters hands-on training and close collaboration with the team, especially during your onboarding phase. (Candidates should be able to commute to our location and be prepared for an in-office schedule.)
- Professional Setting: Expect a typical office setting within the insurance department, with all necessary tools and resources provided. We uphold a collaborative and supportive workplace culture focused on professional growth and excellence in service.
Compensation & Benefits
We offer a competitive salary commensurate with experience, along with a comprehensive benefits package including health and dental insurance, paid time off, and professional development opportunities.
Join us to play a key role in delivering accurate, fair, and prompt dental claims services. If you have the expertise and passion for ensuring quality in claims processing, we encourage you to apply and become part of our dedicated team.
Job Types: Full-time, Part-time
Pay: $19.00 - $26.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Paid training
Work Location: In person
