Claims Research & Resolution Supervisor

Become a Part of Our Caring Community and Help Us Put Health First

As a Claims Research & Resolution Supervisor, you will manage claims operations that involve customer contact, investigation, and settlement of claims for and against our organization, including approval. Reporting to the Claims Research and Resolution Manager, you will follow established guidelines. You will apply independent judgment to analyze variable factors and resolve issues. Additionally, you will collaborate with management and specialists to select appropriate methods and analytical techniques.

The Claims Research & Resolution Supervisor Will:

• Oversee approximately 14-18 direct reports
• Work with insurance companies, providers, members, and collection services in the settlement of claims.
• Manage a team comprised of a group of claims associates researching the resolution to a corrected claim.
• Make decisions that are typically related to schedules, plans and daily operations.
• Perform escalated or more complex similar work and manage a group of support and technical associates.
• Provide daily oversight to associates.
• Ensure consistency in execution across team.
• Hold team members accountable for following established policies.

Required Qualifications

Use your skills to make an impact:

• Minimum three (3) years of claims research and resolution experience
• Minimum two (2) years of team lead and/or management experience over direct reports, with demonstrated ability to develop associates through coaching and sharing feedback
• Proficiency with Microsoft Office programs including Outlook, Excel, Word and PowerPoint
• Experience managing multiple tasks, competing priorities and meeting deadlines.

Preferred Qualifications

• Inventory Management Experience

Additional Information

Work-at-Home Information

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours: 40

Key skills/competency

• Claims Resolution
• Claims Research
• Team Leadership
• People Management
• Operational Oversight
• Customer Contact
• Investigation
• Settlement Processes
• Microsoft Office
• Accountability