Claims Supervisor

Centene Corporation

. Oversee the day-to-day work functions of the assigned claims area .

Posted 11/6/2026full-timeRemote • Illinois • United StatesJuniorMid-Level💰 $56,200 - $101,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims processing and management, ensuring compliance with state and federal regulations while driving operational excellence through process improvement and effective leadership.

Highest-signal resume keywords

Claims ProcessingRegulatory ComplianceLeadership ExperienceReporting and AnalysisComplex Claims Resolution

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims Inventory ManagementProcess ImprovementPolicy DevelopmentCost ControlOperational Analysis

Soft Skills

Problem SolvingCommunicationTeam LeadershipStakeholder Management

Industry Keywords

Health InsuranceMedicaidMarketplaceMedicareClaims Lifecycle

About the role

Key responsibilities & impact

Oversee the day-to-day work functions of the assigned claims area
Provide technical and leadership support to staff to resolve complex issues
Develop and implement policies and procedures compliant with state and federal regulations
Drive process improvement and cost control to process medical claims accurately and timely
Serve as liaison between internal customers, vendors and other claims lifecycle stakeholders
Ensure claims inventory is managed accurately, timely and within compliance requirements
Prioritize daily work volumes through reporting, load balancing and operational overtime management
Identify improvement opportunities and resolve operational gaps using financial, regulatory, cost/benefit and stakeholder-experience considerations
Review, investigate, adjust and resolve pending and complex claims; serve as escalation point
Monitor claims quality reviews, document results and identify trends and systemic root causes
Research, collect background information and documentation, and address issues across teams and departments
Prepare reporting, analysis and insights to drive operational excellence
Maintain records, files and documentation
Complete special projects and facilitate change
Perform other assigned duties and comply with policies and standards

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Associate degree in related field or equivalent experience required
2+ years of health insurance industry, claims processing, physician’s office or other office services experience required
Previous experience in a supervisory/lead role with defined outcomes required
Experience with Medicaid, Marketplace and/or Medicare preferred
Ability to oversee claims inventory accurately, timely and within internal and regulatory requirements
Knowledge of state and federal regulations
Experience with reporting, analysis and insights
Experience reviewing, investigating, adjusting, and resolving claims, especially complex claims

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plan
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity