Supervisor, Claims

Alliance Health

. Oversee claims data entry, payments, credits, adjustments, claims auditing, productivity, complex decision-making, and information management system analysis .

Posted 10/23/2026full-timeMorrisville • North Carolina • United StatesMid-LevelSenior💰 $69,592 - $88,729 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in claims management, including data entry, auditing, and compliance with Medicaid and IPRS regulations. Proven ability to lead teams, develop training programs, and implement operational improvements while fostering a positive and inclusive work environment.

Highest-signal resume keywords

Claims Leadership ExperienceStatistical AnalysisPolicy DevelopmentCustomer Service SkillsKnowledge of Medicaid and IPRS Rules

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims Data EntryClaims AuditingPerformance ReportingFinancial Systems KnowledgeReport PresentationComplex Problem SolvingWorkflow PrioritizationDecision MakingResearch TechniquesCPT Code Knowledge

Soft Skills

Team LeadershipCommunication SkillsConflict ResolutionRelationship BuildingCoaching and Mentoring

Industry Keywords

Behavioral HealthcareClaims ResolutionBilling and ReimbursementProvider NetworkData Governance

About the role

Key responsibilities & impact

Oversee claims data entry, payments, credits, adjustments, claims auditing, productivity, complex decision-making, and information management system analysis
Provide training and development for Claims Research Analyst team members
Guide and oversee training and technical assistance for provider agencies
Compile performance reports, monitor measures, evaluate operational needs, and assess claims production and quality
Implement procedures and updates directed by the Claims Manager/Sr. Director
Ensure claims resolution, escalation, billing and reimbursement system maintenance, and compliance with policies and regulations
Review reports to track processes, improve productivity, and monitor department standards
Assist Claims Research Analysts with claim errors
Develop and modify policies and procedures for valid claims and settlements
Ensure providers are paid according to prompt-pay guidelines
Track special projects and obtain additional provider information
Identify inefficiencies and support resolution of claims barriers
Recruit, train, organize, coach, mentor, and develop staff in collaboration with Human Resources and Claims leadership
Promote a positive, diverse, inclusive, respectful, and ethical working environment
Set performance goals, provide feedback, resolve conflicts, and encourage cross-team collaboration
Collaborate with Contracts, Credentialing, Enrollment, Provider Network, and Utilization Management teams
Participate in Peer Reviews, Data Analytics, Data Governance, Appeals, and Grievance Resolutions

Requirements

What you’ll need

Bachelor’s degree from an accredited college or university in Business Administration or related field
Three (3) years of claims leadership experience with focus in leading projects and people
Ability to resolve complex problems that require the evaluation of alternative methods and solutions
Ability to set objectives, delegate, and prioritize workflow
Proficient in written and oral communication sufficient to handle projects and problems
Ability to develop strong working relationships
Proficient in the techniques of research, statistical analysis and report presentation
Ability to make prompt decisions on complex matters and make evaluations concerning day to day operations
Ability to prepare concise and accurate reports and plans
Working knowledge of financial and budgeting systems
Excellent customer service skills
Knowledge of Medicaid and IPRS rules
Experience in Behavioral Healthcare agency and knowledge of CPT codes, Medicaid, and IPRS preferred

Benefits

Comp & perks

Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility