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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