Healthcare Claims Supervisor

General Dynamics
Anywhere
Workplace: RemoteFull timeUSD 59,500 - 80,500Function: Healthcare (Clinical, Medical, Wellness)Experience: 3+ yearsSkills: ["Communication","Coaching","Mentoring","Analytical thinking","Attention to detail"]

Supervise day-to-day operations of a medical claims processing team for a high-volume TPA environment supporting the World Trade Center Health Program. Ensure accurate, compliant, and timely adjudication of professional, facility, and complex claim types. Oversee staffing, productivity, quality reviews, and process improvements; mentor and train staff; serve as a subject-matter escalation resource; track operational metrics; and collaborate cross-functionally to resolve discrepancies while maintaining HIPAA and confidentiality requirements.

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General Dynamics
General Dynamics
1 day ago

Healthcare Claims Supervisor

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Last checked: 10 hours agoStatus: Live

Job Summary

Supervise day-to-day operations of a medical claims processing team for a high-volume TPA environment supporting the World Trade Center Health Program. Ensure accurate, compliant, and timely adjudication of professional, facility, and complex claim types. Oversee staffing, productivity, quality reviews, and process improvements; mentor and train staff; serve as a subject-matter escalation resource; track operational metrics; and collaborate cross-functionally to resolve discrepancies while maintaining HIPAA and confidentiality requirements.
Location: Anywhere
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Manager level

Key Responsibilities

  • •Supervise day-to-day operations for a medical claims processing team reviewing, analyzing, and adjudicating professional, facility, and complex claim types.
  • •Oversee workload distribution, staffing coverage, productivity expectations, and performance monitoring to meet contractual timeliness and accuracy standards.
  • •Provide coaching, mentoring, and training on claims rules, system changes, program policy updates, and adjudication procedures; conduct quality reviews and implement process improvements.
  • •Serve as a subject matter resource for escalations, benefit interpretations, complex claims, and policy questions; ensure proper documentation and audit-ready recordkeeping.
  • •Collaborate with Medical Policy, Utilization Management, Finance, Provider Services, and Compliance teams to resolve claim discrepancies and coding issues; track metrics and support testing/validation of system and workflow updates while ensuring HIPAA and confidentiality.

Pay and Benefits

Salary: USD 59,500 - 80,500
Perks:Health InsuranceDentalVision401kPaid Leave

Key Requirements

  • •5+ years of experience in medical claims processing within a payer, TPA, or government healthcare environment.
  • •2+ years of lead, senior, or supervisory experience supporting claims operations.
  • •Strong understanding of claims adjudication, reimbursement methodologies, and regulatory requirements.
  • •Knowledge of professional and facility claim formats, modifiers, bill types, and industry-standard adjudication rules.
  • •Proficiency with claims processing systems (Plexis is a plus), plus strong analytical skills for interpreting claims data and resolving issues.
Experience:3+ yearsMedical claimsHealthcareTPAGovernment healthcare
Skills:CommunicationCoachingMentoringAnalytical thinkingAttention to detail
Tech Stack:Plexis

Eligibility

Work Authorization:Sponsorship available.
Security Clearance:MBI (T2)

Company Brief

General Dynamics
Provides IT, systems engineering, cybersecurity, cloud, and mission support services to U.S. federal civilian and defense agencies, delivering large-scale technology solutions and managed services for national security and government operations.
Industry: Defense Technology
Company Size: Enterprise (1,001+ employees)
Growth: Established Company
Headquarters: Tysons / Fairfax, United States
WebsiteLinkedIn