Senior Claims Supervisor (TPA / Anthem Experience)

This role is not focused on high-volume claims processing.

You’ll be a strong fit if you:

  • Have worked in a TPA or self-funded environment
  • Have experience with Anthem Blue Cross Blue Shield claims
  • Can independently troubleshoot issues involving eligibility, pricing, and claim routing
  • Are comfortable working across TPA, carrier, and provider systems

About the Role

We’re looking for a hands-on Claims Supervisor who understands how claims actually move across systems — and how to resolve issues when they don’t.

This role is ideal for someone who can think beyond processing, guide a team through complex claim scenarios, and reduce escalations by solving problems at the root.

What You’ll Do

  • Lead and support a claims team within a TPA / self-funded environment
  • Troubleshoot complex claim issues involving:
  • Eligibility discrepancies
  • Network determination
  • Pricing and adjudication issues
  • Claims routing across systems
  • Investigate and resolve claims requiring coordination between:
  • TPA
  • Anthem
  • Provider offices
  • Coach team members on how to analyze and resolve claims issues, not just process them
  • Identify root causes and reduce unnecessary escalations

What Makes Someone Successful Here

  • Experience working in a TPA or self-funded health plan environment
  • Experience working with Anthem claims systems and processes
  • Proven ability to independently troubleshoot:
  • Eligibility
  • Pricing
  • Claims routing
  • Comfortable working across multiple systems and partners
  • Strong problem-solver who does not default to escalation

Work Environment:

Fully remote position (must have reliable internet access and a quiet workspace).
Scheduled within the following timeframes to incorporate a 40-hour work week, with a full 8-hour workday.

Our operating hours are as follows:
Monday–Friday: 7:00 a.m. CST – 5:30 p.m. CST
Saturday: 8:00 a.m. CST – 4:00 p.m. CST
Sunday: 8:00 a.m. CST – 12:00 p.m. CST

Compensation and Benefits:

Salary Range: $70,000 - $80,000

Benefits Include:
Medical, Dental, and Vision Insurance
Company-paid Life Insurance
Paid Time Off and Holidays
Remote Work Flexibility

Job Type: Full-time

Pay: From $80,000.00 per year

Benefits:

  • Dental insurance
  • Paid time off
  • Vision insurance

Application Question(s):

  • How many years of experience do you have working with Anthem Blue Cross Blue Shield claims, including resolving issues across plans, systems, or regions?

None
Less than 1 year
1–3 years
3–5 years
5+ years

  • Which of the following have you worked with? (Select all that apply)

TPA / self-funded plans
Anthem claims
Provider offices (resolving claim issues)
Eligibility discrepancies
Claim pricing / repricing issues
Claims routing across systems

  • How many years of experience do you have independently troubleshooting claim issues (such as eligibility, pricing, or routing) without escalation?

None
Less than 1 year
1–3 years
3–5 years
5+ years

  • How many years of experience do you have working in a TPA or self-funded health plan environment?

None
Less than 1 year
1–3 years
3–5 years
5+ years

  • If you selected 1+ years, please list the employer(s) where you gained this experience. If no experience put N/A.

Work Location: Remote

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