Supervisor, Health & Welfare Claims
Central States Funds/TeamCare, Chicago, IL, United States
Position Summary
The Supervisor, Health & Welfare Claims is responsible for leading a team of Claims Adjusters and overseeing the accurate, timely, and compliant processing of health and welfare claims. The role serves as a key operational resource, providing day‑to‑day direction, staff development, and escalation support while maintaining the high standards of service our members depend on. The Supervisor works cross‑functionally with internal teams and external partners, including PPO Network Representatives, to resolve issues, drive process consistency, and ensure claims are processed within established deadlines.
Responsibilities
Lead, mentor, and develop a team of Claims Adjusters, fostering a culture of accountability, continuous improvement, and exceptional service delivery.
Oversee and optimize claims workflow to ensure all claims are processed accurately and within the required 30‑day processing deadline.
Personally adjudicate high‑value claims in accordance with established thresholds and plan guidelines, ensuring accuracy and compliance.
Serve as the primary escalation point for complex or disputed claims, providing guidance and resolution support to staff.
Partner with PPO Network Representatives to resolve claims inquiries, discrepancies, and issues in a timely and professional manner.
Collaborate with fellow supervisors and department managers to align operational strategies and drive consistency across the claims processing function.
Design and deliver onboarding and ongoing training programs that equip staff with the knowledge and tools needed to perform at their best.
Conduct annual performance evaluations and manage employee relations matters with professionalism, fairness, and a coaching mindset.
Qualifications
Supervisory or team lead experience strongly preferred.
Claims processing experience required.
Bachelor’s degree preferred.
In‑depth knowledge of Health & Welfare benefit plans.
Experience with Facets claims processing system (or a similar system) strongly preferred.
Strong analytical and problem‑solving skills, with a demonstrated ability to research, interpret, and resolve complex claims issues.
Exceptional interpersonal and communication skills, with the ability to effectively engage with team members, cross‑functional partners, and external vendors.
Highly organized and self‑directed, with the ability to manage competing priorities in a deadline‑driven environment.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook); experience with claims management or benefits administration software.
Compensation
Annual Salary Range:
$75,000 – $88,000 annually. The posted range represents the anticipated pay scale for this position. Final pay will be determined based on a variety of job‑related factors including skills, experience, education, certifications, internal equity, and organizational needs.
Benefits
100% company‑paid family insurance benefits including health, dental, RX, and vision.
100% company‑funded pension plan (at no cost to the employee).
Health care and dependent care Flexible Spending Accounts (FSAs).
401(k) retirement plan with company match.
Paid vacation and PTO days.
Flexible start times & hybrid work‑from‑home schedule.
Lunch stipend for onsite café.
Tuition reimbursement.
Benefits described above are subject to change at the company’s discretion.
Equal Opportunity Employer
Equal Opportunity Employer
#J-18808-Ljbffr
The Supervisor, Health & Welfare Claims is responsible for leading a team of Claims Adjusters and overseeing the accurate, timely, and compliant processing of health and welfare claims. The role serves as a key operational resource, providing day‑to‑day direction, staff development, and escalation support while maintaining the high standards of service our members depend on. The Supervisor works cross‑functionally with internal teams and external partners, including PPO Network Representatives, to resolve issues, drive process consistency, and ensure claims are processed within established deadlines.
Responsibilities
Lead, mentor, and develop a team of Claims Adjusters, fostering a culture of accountability, continuous improvement, and exceptional service delivery.
Oversee and optimize claims workflow to ensure all claims are processed accurately and within the required 30‑day processing deadline.
Personally adjudicate high‑value claims in accordance with established thresholds and plan guidelines, ensuring accuracy and compliance.
Serve as the primary escalation point for complex or disputed claims, providing guidance and resolution support to staff.
Partner with PPO Network Representatives to resolve claims inquiries, discrepancies, and issues in a timely and professional manner.
Collaborate with fellow supervisors and department managers to align operational strategies and drive consistency across the claims processing function.
Design and deliver onboarding and ongoing training programs that equip staff with the knowledge and tools needed to perform at their best.
Conduct annual performance evaluations and manage employee relations matters with professionalism, fairness, and a coaching mindset.
Qualifications
Supervisory or team lead experience strongly preferred.
Claims processing experience required.
Bachelor’s degree preferred.
In‑depth knowledge of Health & Welfare benefit plans.
Experience with Facets claims processing system (or a similar system) strongly preferred.
Strong analytical and problem‑solving skills, with a demonstrated ability to research, interpret, and resolve complex claims issues.
Exceptional interpersonal and communication skills, with the ability to effectively engage with team members, cross‑functional partners, and external vendors.
Highly organized and self‑directed, with the ability to manage competing priorities in a deadline‑driven environment.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook); experience with claims management or benefits administration software.
Compensation
Annual Salary Range:
$75,000 – $88,000 annually. The posted range represents the anticipated pay scale for this position. Final pay will be determined based on a variety of job‑related factors including skills, experience, education, certifications, internal equity, and organizational needs.
Benefits
100% company‑paid family insurance benefits including health, dental, RX, and vision.
100% company‑funded pension plan (at no cost to the employee).
Health care and dependent care Flexible Spending Accounts (FSAs).
401(k) retirement plan with company match.
Paid vacation and PTO days.
Flexible start times & hybrid work‑from‑home schedule.
Lunch stipend for onsite café.
Tuition reimbursement.
Benefits described above are subject to change at the company’s discretion.
Equal Opportunity Employer
Equal Opportunity Employer
#J-18808-Ljbffr