Healthcare Claims Operations Supervisor - Remote

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    "jobOpeningName": "Healthcare Claims Operations Supervisor - Remote",
    "departmentLabel": "Claims Adjudication",
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    "datePosted": "2026-05-21",
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    "description": "<p><span style=\"color: rgb(186, 55, 42); font-size: 18pt; font-weight: bold\">Healthcare Claims Supervisor - Remote</span></p>\n<p><br></p>\n<p><span style=\"font-weight: bold\">Job Type: Full-time </span></p>\n<p><span style=\"font-weight: bold\">Location: Remote</span></p>\n<p><span style=\"font-weight: bold\">Reports To: Claims Manager / Director of Claims</span></p>\n<p><br></p>\n<p><span style=\"font-size: 14pt; text-decoration: underline\"><span style=\"font-weight: bold\">Position Summary</span></span></p>\n<p>The Healthcare Claims Operations Supervisor is responsible for the overall operational performance, client satisfaction, KPI achievement, reporting oversight, and leadership of assigned healthcare claims accounts. This role oversees Team Leads and Claims Examiners while serving as a key liaison between clients and internal departments including Operations, Quality, Training, Workforce Management, and Account Management.</p>\n<p><br></p>\n<p>The Supervisor is accountable for ensuring production, quality, turnaround time, attendance, compliance, and service-level expectations are consistently achieved. This individual must be highly organized, data-driven, proactive, and capable of managing both operational execution and client relationships in a fast-paced environment.</p>\n<p><br></p>\n<p>Success in this role requires the ability to identify operational risks early, drive corrective actions, maintain strong client confidence, and foster a culture of accountability, performance, and continuous improvement.</p>\n<p><br><span style=\"font-size: 14pt; text-decoration: underline\"><span style=\"font-weight: bold\">Key Responsibilities</span></span></p>\n<p><span style=\"font-weight: bold\">Operational Leadership &amp; Accountability</span></p>\n<ul>\n<li>Oversee daily claims operations across assigned accounts and lines of business.</li>\n<li>Ensure achievement of all client KPIs, SLAs, quality standards, and operational deliverables.</li>\n<li>Monitor productivity, inventory, aging, turnaround times, workflow distribution, attendance, and backlog risks.</li>\n<li>Develop and execute action plans to address performance gaps and operational challenges.</li>\n<li>Partner with Workforce Management and Operations Leadership on staffing, forecasting, and capacity planning.</li>\n<li>Support implementations, transitions, and account expansions to ensure operational readiness.</li>\n<li>Successfully complete training and demonstrate proficiency in assigned claims processes.</li>\n</ul>\n<p><br></p>\n<p><span style=\"font-weight: bold\">Performance &amp; KPI Management</span></p>\n<ul>\n<li>Maintain ownership of account-level operational metrics and performance outcomes.</li>\n<li>Analyze trends related to productivity, quality, error rates, SLA compliance, attendance, inventory aging, and client escalations.</li>\n<li>Hold Team Leads and staff accountable through coaching, performance reviews, corrective actions, and performance improvement plans.<br></li>\n<li>Drive a culture of urgency, accountability, and continuous improvement.<br></li>\n<li>Ensure timely resolution of performance issues and consistent execution of operational expectations.</li>\n</ul>\n<p><br><span style=\"font-weight: bold\">Client Management &amp; Client Satisfaction</span></p>\n<ul>\n<li>Serve as a primary operational contact for assigned client accounts.<br></li>\n<li>Participate in weekly, monthly, and quarterly business reviews, client meetings, calibrations, and operational discussions.<br></li>\n<li>Build strong client relationships through proactive communication and consistent operational performance.<br></li>\n<li>Manage client concerns and escalations with clear ownership, timely follow-through, and effective resolution.<br></li>\n<li>Collaborate with Account Management and Leadership to support client satisfaction, retention, and growth.</li>\n</ul>\n<p><br><span style=\"font-weight: bold\">Reporting &amp; Metrics Management</span></p>\n<ul>\n<li>Prepare, analyze, and present operational reports, dashboards, and performance metrics.<br></li>\n<li>Deliver accurate and timely reporting to clients and internal leadership.<br></li>\n<li>Identify trends, risks, and opportunities through data analysis and recommend actionable solutions.<br></li>\n<li>Utilize Excel, Power BI, client systems, and operational reporting tools to monitor account performance.<br></li>\n<li>Present performance results, improvement initiatives, and operational recommendations professionally and effectively.</li>\n</ul>\n<p><br><span style=\"font-weight: bold\">Quality, Compliance &amp; Process Improvement</span></p>\n<ul>\n<li>Ensure compliance with client requirements, HIPAA regulations, CMS guidelines, and company policies.</li>\n<li>Partner with Quality Assurance teams on calibrations, audits, error trend analysis, and remediation efforts.</li>\n<li>Conduct root cause analysis and implement corrective actions to improve quality and efficiency.</li>\n<li>Support audit readiness, compliance initiatives, and process improvement programs.</li>\n</ul>\n<p><br><span style=\"font-weight: bold\">Team Leadership &amp; Development</span></p>\n<ul>\n<li>Coach, mentor, and develop Team Leads and Claims Examiners.</li>\n<li>Support onboarding, nesting, cross-training, and ongoing employee development.</li>\n<li>Reinforce leadership accountability and operational excellence.</li>\n<li>Promote employee engagement, retention, succession planning, and professional growth.</li>\n<li>Foster a culture of teamwork, ownership, professionalism, and high performance.</li>\n</ul>\n<p><br><span style=\"font-size: 14pt; text-decoration: underline\"><span style=\"font-weight: bold\">Key Performance Indicators (KPIs)</span></span></p>\n<ul>\n<li>Production Goal Achievement</li>\n<li>SLA Compliance</li>\n<li>Quality Scores (Target: 98%–100%)</li>\n<li>Inventory &amp; Aging Management</li>\n<li>Attendance &amp; Adherence</li>\n<li>Client Satisfaction</li>\n<li>Escalation Resolution Timeliness</li>\n<li>Reporting Accuracy &amp; Timeliness</li>\n<li>Reduction of Repeat Errors</li>\n<li>Employee Retention &amp; Engagement</li>\n<li>Coaching and Performance Documentation Compliance<br></li>\n</ul>\n<p><br><span style=\"font-size: 14pt; text-decoration: underline\"><span style=\"font-weight: bold\">Qualifications</span></span></p>\n<ul>\n<li><span style=\"font-weight: bold\">Minimum 3–5 years of healthcare claims leadership experience.</span></li>\n<li><span style=\"font-weight: bold\">Prior supervisory experience overseeing production teams required.</span></li>\n<li>Strong experience managing healthcare payer operations and claims workflows.</li>\n<li>Experience with client-facing operations and client relationship management.</li>\n<li><span style=\"font-weight: bold\">Strong reporting and data analysis experience required.</span></li>\n<li>Experience owning operational KPIs and performance deliverables.</li>\n<li>Strong leadership, accountability, organizational, and communication skills.</li>\n<li>Experience with systems such as EZ-CAP, QNXT, Facets, Jiva, Plexis, or similar preferred.</li>\n<li><span style=\"font-weight: bold\">Intermediate to advanced Excel and reporting/dashboard experience required.</span></li>\n<li>Experience managing offshore and/or remote teams preferred.</li>\n</ul>\n<p><br></p>\n<p><span style=\"font-size: 14pt; text-decoration: underline\"><span style=\"font-weight: bold\">What We Offer</span></span></p>\n<ul>\n<li><span style=\"font-size: 12pt; font-weight: bold\">Remote work offered</span></li>\n<li><span style=\"font-size: 12pt; font-weight: bold\">Equipment provided</span></li>\n<li><span style=\"font-size: 12pt\"><span style=\"font-weight: bold\">Paid training</span> to set you up for success</span></li>\n<li><span style=\"font-size: 12pt\"><span style=\"font-weight: bold\">Comprehensive benefits:</span> Medical, Dental, Vision, Life, HSA, 401(k)</span></li>\n<li><span style=\"font-size: 12pt; font-weight: bold\">Paid Time Off (PTO)</span></li>\n<li><span style=\"font-size: 12pt; font-weight: bold\">7 paid holidays</span></li>\n<li><span style=\"font-size: 12pt\">A supportive team and a company that values internal growth</span></li>\n</ul>\n<p><br></p>\n<p><span style=\"font-size: 12pt\"><span style=\"color: rgb(186, 55, 42); font-size: 18pt; font-weight: bold\">Ready to Take the Lead on Something New?</span><br><span style=\"font-size: 14pt\">Don’t miss this opportunity to shape a new client launch—click “<span style=\"color: rgb(186, 55, 42); font-weight: bold\">Apply Now</span>” and get started.</span></span><br></p>\n<p><span style=\"font-size: 12pt\"><br></span><br></p>\n<p><span style=\"text-decoration: underline\"><span style=\"font-size: 12pt; font-weight: bold\">COMPANY OVERVIEW</span></span><br></p>\n<p><span style=\"font-size: 12pt\">Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.</span></p>\n<p><br></p>\n<p><span style=\"font-size: 12pt\">The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.</span></p>\n<p><br></p>\n<p><span style=\"font-size: 12pt\">Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.</span></p>",
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