You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client believes in changing healthcare for the good by making the system more accessible and transparent. As a Claims Supervisor, you will be part of a digital-first, data-driven health plan that is replacing legacy systems with modern infrastructure. You will oversee a dedicated group of team members, ensuring qualitative and quantitative metrics are met. Your responsibilities will include supervising, mentoring, training, and evaluating a team of claims processors and specialists.

Key Responsibilities

• Lead a team of dedicated professionals with a focus on delivering timely, high-quality claim outcomes.
• Monitor daily claim processing activities to ensure established performance metrics and service-level standards are consistently met.
• Ensure all claim processing complies with internal policies as well as state and federal regulations. Participate in control audits and implement corrective action plans as needed.
• Develop, write, and maintain resource documents to support team accuracy and serve as reliable reference materials.
• Serve as an escalation point for complex or disputed claims, customer concerns, and provider inquiries, ensuring timely and professional resolution.
• Analyze claim data to identify trends and opportunities for operational enhancement; collaborate with the Head of Claims to implement prompt and effective solutions.
• Create individualized training plans and collaborate with the team’s dedicated trainer to support continuous growth and development for each team member.

Qualifications

• Minimum of three to five years of experience in healthcare claims, including prior leadership or supervisory responsibilities.
• Strong understanding of healthcare claims adjudication, medical terminology, and coding systems (ICD-10, CPT).
• Knowledge of and/or hands-on experience working in a startup environment.

Skills

• Excellent leadership, problem-solving, analytical, and communication skills.
• Proficiency in claims management software.
• Proficiency in Google Drive and Google Sheets.
• VBA experience is a plus.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients