Claims Service Supervisor- West Sacramento, CA (Hybrid)

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards, offering incredible opportunities to grow your career in a company that values your contributions and prioritizes work flexibility, learning, and career development.

About the Role

As a Claims Service Supervisor, you will oversee the day-to-day operations of a healthcare claims processing team, ensuring claims are adjudicated accurately, efficiently, and in compliance with regulatory requirements and client contracts. You will provide leadership, coaching, quality oversight, and operational support to claims examiners and analysts while driving continuous process improvements and service excellence.

Responsibilities

• Supervise and lead a team of healthcare claims examiners and analysts.
• Monitor claim inventory, turnaround times, productivity, and quality metrics to ensure service level agreements (SLAs) are achieved.
• Assume supervisory responsibility for electronic and paper claims submissions; oversee analysis, correction, and eligibility of edits and errors.
• Analyze claim trends, denial patterns, and operational performance data to identify process improvement opportunities.
• Develop and maintain standard operating procedures (SOPs) and training materials.
• Lead, motivate, coach, and develop team members while addressing performance concerns and taking corrective action when necessary.
• Conduct employee performance evaluations and development planning.
• Promote best practices across all levels of the team to improve consistency, productivity, and quality.
• Use Microsoft Excel to analyze operational data, reconcile information, identify trends, and prepare reports for leadership.
• Monitor and report on team performance, including productivity, quality, inventory, and throughput metrics.
• Identify workflow challenges, reporting discrepancies, and opportunities to improve team processes, accuracy, and efficiency.
• Collaborate regularly with Workforce Management, Quality, Operations, project teams, and leadership stakeholders.
• Participate in project meetings, client-facing preparation, client interface, and operational planning activities as needed.

Requirements

• 3-5+ years of experience in healthcare operations or Medicaid-related functions.
• 5+ years of supervisory or people leadership experience.
• Experience in one or more of the following areas: medical billing, claims adjudication, medical records, or healthcare analytics.
• Experience managing performance metrics, including KPIs, SLAs, productivity, and quality standards.
• Excellent communication and interpersonal skills with the ability to engage effectively in a client-facing environment.
• Ability to manage multiple priorities, meet deadlines, and operate effectively in a fast-paced, high-volume environment.
• Strong proficiency in Microsoft Excel, including the ability to analyze data, reconcile information, identify discrepancies, and produce operational reports.

Work Environment

• Fast-paced, metrics-driven claims environment requiring prioritization and timely decision-making.
• Hybrid role predominantly work-from-home, with occasional in-office work required based on business, operational, client, or leadership needs.
• Must be willing to work Monday through Friday, 7:00 AM to 4:00 PM.
• Video cameras must be used during all interviews and the initial week of orientation.
• To work effectively as a teleworker or hybrid employee, you must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload (higher speeds recommended).

Pay

The pay range for this position is $60,000–$82,044 per year. The base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Benefits

• Generous, flexible vacation policy for salaried, full-time employees.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Leadership and technical development academies to build skills and capabilities.