Claims Supervisor

India·Bangaloremid

OtherSupervisor

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Quick Summary

Key Responsibilities

- 1) Team Leadership & Daily Operations Supervise day-to-day claims processing operations to meet SLA/TAT, productivity, and quality targets. Allocate work, manage volumes, and ensure queue hygiene,

Requirements Summary

- 1) Team Leadership & Daily Operations Supervise day-to-day claims processing operations to meet SLA/TAT, productivity, and quality targets. Allocate work, manage volumes, and ensure queue hygiene,

Technical Tools

OtherSupervisor

What We Offer

~1 min read

✓Global insurance claims processing for individual, employer and group.

The Claims Supervisor will lead a team responsible for accurate and timely processing of healthcare claims (professional/institutional) while ensuring adherence to client policies, regulatory requirements, and internal quality standards. This role focuses on daily operations management, team performance, quality/compliance, production attainment, people leadership, and continuous improvement across claims processing workflows.

Responsibilities

~1 min read

Supervise day-to-day claims processing operations to meet SLA/TAT, productivity, and quality targets.
Allocate work, manage volumes, and ensure queue hygiene, balanced distribution, and timely completion of deliverables.
Provide floor support and real-time resolution for processing queries and escalations.

Guide the team on claims handling across key areas such as:
- Claims intake, validation, adjudication support and pends
- Error identification and correction, resubmissions, and recoupment workflows (as applicable)
- Coordination of Benefits (COB)
Ensure correct application of standard claims concepts (as applicable to process):
- Eligibility, benefits, pre-auth/referrals, medical necessity indicators
- Code familiarity: CPT/HCPCS/ICD-10 (conceptual), modifiers, NCCI awareness (nice-to-have)

Drive adherence to SOPs, WIs, and control checks; ensure zero tolerance compliance items are met.
Conduct regular audits/quality calibrations, coach for error reduction, and maintain documentation for governance.
Ensure process alignment with HIPAA/privacy norms and internal data handling guidelines.

Set clear expectations, conduct huddles/1:1s, and provide ongoing coaching on quality, productivity, and behaviors.
Create development plans for team members; identify training needs and coordinate refreshers.
Manage attendance, schedule adherence, and engagement levers; address performance gaps through structured action plans.

Provide daily/weekly operational updates to managers and cross-functional teams (Quality, Training, WFM, Tech).
Participate in client calls as needed, share performance narratives, and support action plan tracking.
Drive effective escalation management with clear RCA and preventive actions.

Identify defect trends, run basic analysis, and implement corrective/preventive actions.
Lead mini-projects to improve First Pass Yield (FPY), reduce rework, and improve throughput.
Support digitization/automation initiatives (macros, workflow improvements, knowledge articles) in partnership with OE/Tech.

SLA / TAT adherence (queue-based and end-to-end as applicable)
Productivity / throughput per FTE
Quality score / audit compliance / error rate
Rework reduction, FPY improvement
Shrinkage/attendance, schedule adherence
Team attrition, engagement, coaching effectiveness
Client/Stakeholder satisfaction and escalation closure timeliness

Requirements

~1 min read

5–6 years of experience in International Healthcare Claims Operations (payer/TPA/provider revenue cycle claims teams supporting payer processes).
Minimum 3–4 years in a lead/team supervisor/team lead.
Strong understanding of claims concepts: adjudication flow, denials, adjustments, benefits/eligibility basics.
Ability to interpret SOPs, apply judgement, and drive operational discipline.
Excellent communication (verbal/written), stakeholder management, and people leadership skills.
Strong working knowledge of MS Office (Excel, PowerPoint); comfort with dashboards and trackers.

Nice to Have

~1 min read

Experience with claims platforms/workflows (payer tools), OCR/intake tools, or BPM/queue management systems.
Exposure to Lean/Six Sigma, Kaizen, or structured CI methods.
Prior experience working in regulated environments with audit rigor (internal/external).
Familiarity with provider contracting concepts and network/COB scenarios.

Customer-first mindset with strong attention to detail
Bias for action and outcome orientation
Strong analytical and problem-solving capability
Ability to lead through change; coach and motivate teams
High integrity, compliance orientation, and confidentiality handling

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.