TPA Claims Supervisor - Remote

Overview

We are seeking a collaborative and detail-oriented TPA Claims Supervisor to lead our claims processing operations for PACE programs. In this role, you’ll manage and mentor the claims coordinator team, drive operational improvements, and ensure service-level targets and compliance requirements are consistently met.

In Short

• Lead end-to-end claims operations, ensuring accuracy and timeliness.
• Monitor claims metrics to drive improvements.
• Support growth of claims coordinators through training.
• Identify opportunities for process optimization.
• Ensure compliance with internal policies and regulations.
• Develop and maintain standard operating procedures.
• Communicate professionally with stakeholders.
• Facilitate team meetings to promote alignment.
• Support resolution of escalated issues.
• Use data to recommend strategies for improvement.

Requirements

• 1–3 years of leadership experience in healthcare.
• 3–5 years of hands-on claims processing experience.
• Strong knowledge of Medicare, Medicaid, and PACE programs.
• Familiarity with healthcare coding and reimbursement.
• Experience interpreting data for performance improvement.
• Strong communication skills.
• Ability to manage multiple tasks in a fast-paced setting.
• Experience drafting departmental policies.

Benefits

• Virtual-first culture with a collaborative team.
• Competitive health benefits.
• 401(k) with company contribution.
• Generous paid time off.
• Flexibility to manage schedules.
• Opportunities for professional development.
• Diverse and inclusive workplace.