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FI
Fidelio Insurance
Claims Supervisor
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Based on Pennsylvania data
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What they do
A Claims Supervisor is responsible for a team of claims examiners and associated staff. Oversees team success and ensures that claims practices and procedures comply with contracts, regulations, and guidelines.
$96,955 / year median in Pennsylvania
+2% projected growth
Job Description
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.