What does a claims supervisor do?

Updated January 8, 2025

7 min read

A claims supervisor is in charge of overseeing the workflow and the workforce involved in processing insurance claims, ensuring accuracy and smooth progress. Their responsibilities typically revolve around liaising with key clients and third party agencies, assisting staff in negotiating terms, verifying the authenticity and completeness of all applications, monitoring the finances, and resolving complex issues. Furthermore, as a claims supervisor, it is essential to lead and encourage the team to reach goals, all while making sure that they adhere to the company's policies and regulations.

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Claims supervisor responsibilities

Here are examples of responsibilities from real claims supervisor resumes:

Manage, train and continuously develop a team consisting of both inside SIU investigators and field investigators.
Apply fundamentals of insurance investigation and resolution to an introductory leadership role managing complex claim files and tort litigation files.
Make determinations to authorize payments via XACTIMATE software.
Assist TPA in obtaining company documentation and scheduling employee interviews in investigation of claims.
Advise physician on any changes with CPT and ICD-9 coding to maximize reimbursements and minimize denials.
Provide oversight and direction for highly complicate claim reviews base on policy, procedure and CMS guidelines.
Explain applicability of first party medical benefits (med pay / pip) and coordinate resolution through appropriate departments.
Respond to random states Medicaid audits on eligibility.
Monitor and implement CMS evolving claim processing compliance requirements.
Assist examiners with questions regarding Medicare and Medicaid processing for inpatient and outpatient claims.
Maintain contact with reinsurance companies, specifically on issues that involve litigation or questionable circumstances.
Send all necessary information to TPA whenever an incident occurs and build consistent communication with adjusters.
Mentore less experience and newer employees in career development and individual development plans to facilitate future leadership candidates for the enterprise.
Review and process information, calculate and issue checks for settlement of claims, loans, surrenders and annuities.
Oversee the servicing of all repetitive payment files, including structure settlement, single premium annuities and annual year-end tax reporting.

Claims supervisor skills and personality traits

We calculated that 25% of Claims Supervisors are proficient in Customer Service, Corrective Action, and Claims Adjusters. They’re also known for soft skills such as Analytical skills, Communication skills, and Detail oriented.

We break down the percentage of Claims Supervisors that have these skills listed on their resume here:

Customer Service, 25%
Coordinated department goals, objectives and performance evaluations which ensured accuracy and quality of customer service through effective coaching and feedback.
Corrective Action, 7%
Identify and address individual and departmental trends in quality and production and execute appropriate corrective actions and counseling when necessary.
Claims Adjusters, 6%
Developed Property Claims Adjusters to conduct field based investigations related to policyholder homeowner claims of property damage.
Litigation, 6%
Established and evaluated claim-handling and staff procedures for complex coverage issues involving GL& Non-Standard Automobile liability claims and litigation issues.
Claims Handling, 5%
Conducted training seminars in areas of claims handling and commercial customer relations to new representatives as warranted.
Performance Reviews, 4%
Conducted performance reviews and implemented corrective strategies leading to some terminations while improving communications, morale, and employee satisfaction overall.

Most claims supervisors use their skills in "customer service," "corrective action," and "claims adjusters" to do their jobs. You can find more detail on essential claims supervisor responsibilities here:

Analytical skills. One of the key soft skills for a claims supervisor to have is analytical skills. You can see how this relates to what claims supervisors do because "adjusters and examiners must each evaluate whether the insurance company is obligated to pay a claim and determine the amount to pay." Additionally, a claims supervisor resume shows how claims supervisors use analytical skills: "develop plans, analyze results and oversee work of a litigation claims staff. "

Communication skills. Many claims supervisor duties rely on communication skills. "claims adjusters and investigators must get information from a range of people, including claimants, witnesses, and medical experts," so a claims supervisor will need this skill often in their role. This resume example is just one of many ways claims supervisor responsibilities rely on communication skills: "utilized interpersonal and communications skills to manage claims staff and administer monthly performance evaluations. "

Detail oriented. Another skill that relates to the job responsibilities of claims supervisors is detail oriented. This skill is critical to many everyday claims supervisor duties, as "adjusters, appraisers, examiners, and investigators must carefully review documents and damaged property, because small details can have large financial consequences." This example from a resume shows how this skill is used: "conducted detailed bill review to implement sound litigation management and expense control. "

Interpersonal skills. A big part of what claims supervisors do relies on "interpersonal skills." You can see how essential it is to claims supervisor responsibilities because "adjusters, examiners, and investigators often meet with claimants and others who may be upset by the situation that requires a claim or by the settlement the company is offering." Here's an example of how this skill is used from a resume that represents typical claims supervisor tasks: "provided excellent written, verbal and interpersonal skills to my direct reports as well as the full service unit. "

See the full list of claims supervisor skills

The three companies that hire the most claims supervisors are:

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Compare different claims supervisors

Claims supervisor vs. Insurance adjuster

An adjuster is responsible for evaluating the extent of loss in the company by calculating the damage costs, determining the settlement payment to the client, and managing the reputation of the company for claims accountability. Adjusters must have extensive knowledge of the insurance principles and processes, following the state and federal regulations to protect clients and the business from insurance fraud. They collect documents from different organizations, perform field research, and interview witnesses to verify the accuracy of claims statement.

The annual salary of insurance adjusters is $17,948 lower than the average salary of claims supervisors.While the two careers have a salary gap, they share some of the same responsibilities. Employees in both claims supervisor and insurance adjuster positions are skilled in customer service, claims handling, and coverage issues.

While similarities exist, there are also some differences between claims supervisors and insurance adjuster. For instance, claims supervisor responsibilities require skills such as "corrective action," "claims adjusters," "litigation," and "performance reviews." Whereas a insurance adjuster is skilled in "insurance policies," "auto claims," "catastrophe claims," and "public adjusters." This is part of what separates the two careers.

Insurance adjusters really shine in the insurance industry with an average salary of $60,583. Comparatively, claims supervisors tend to make the most money in the retail industry with an average salary of $102,674.The education levels that insurance adjusters earn slightly differ from claims supervisors. In particular, insurance adjusters are 0.2% less likely to graduate with a Master's Degree than a claims supervisor. Additionally, they're 0.1% less likely to earn a Doctoral Degree.

Claims supervisor vs. Adjuster

An appraiser is someone who assesses the monetary value of a property such as an automobile, real property, and personal claim. His/Her or her responsibilities include resolving disparities between a property's monetary values and preparing narrative reports for projects. The essential skills that an appraiser should possess to accomplish such responsibilities include a keen eye for details, strong communication, analytical, and problem-solving skills, and the ability to work under pressure. The education requirements for the job vary depending on the area of focus.

On average, adjusters earn a $25,867 lower salary than claims supervisors a year.While the salary may differ for these jobs, they share a few skills needed to perform their duties. Based on resume data, both claims supervisors and adjusters have skills such as "customer service," "litigation," and "claims handling. "

While some skills are similar in these professions, other skills aren't so similar. For example, resumes show us that claims supervisor responsibilities requires skills like "corrective action," "claims adjusters," "performance reviews," and "workers compensation." But an adjuster might use other skills in their typical duties, such as, "policy coverage," "auto claims," "insurance coverage," and "police reports."

Adjusters earn a lower average salary than claims supervisors. But adjusters earn the highest pay in the insurance industry, with an average salary of $50,894. Additionally, claims supervisors earn the highest salaries in the retail with average pay of $102,674 annually.adjusters earn similar levels of education than claims supervisors in general. They're 0.7% less likely to graduate with a Master's Degree and 0.1% less likely to earn a Doctoral Degree.

Claims supervisor vs. Appraiser

A medical claims analyst audits or verifies medical claims in insurance companies. Medical claims analysts make sure that corporate reimbursement payments are accurate. Usually, they work at an office on a computer workstation. They receive Medicaid claims from specialty and medical providers for reimbursement. Their job includes the development of an enhanced procedure in handling difficult Medicare/Medicaid letters while complying with the set policies.

On average, appraisers earn lower salaries than claims supervisors, with a $33,040 difference per year.Using the responsibilities included on claims supervisors and appraisers resumes, we found that both professions have similar skill requirements, such as "customer service," "litigation," and "claims handling.rdquo;

There are many key differences between these two careers, including some of the skills required to perform responsibilities within each role. For example, a claims supervisor is likely to be skilled in "corrective action," "claims adjusters," "performance reviews," and "workers compensation," while a typical appraiser is skilled in "appraisal reports," "mai," "discounted cash flow," and "market research."

Appraisers earn the highest salary when working in the insurance industry, where they receive an average salary of $48,145. Comparatively, claims supervisors have the highest earning potential in the retail industry, with an average salary of $102,674.Most appraisers achieve a similar degree level compared to claims supervisors. For example, they're 1.1% more likely to graduate with a Master's Degree, and 0.8% more likely to earn a Doctoral Degree.

Learn more about claims supervisors vs medical claims analysts.

Claims supervisor vs. Medical claims analyst

Medical claims analysts average a lower salary than the annual salary of claims supervisors. The difference is about $28,555 per year.While their salaries may vary, claims supervisors and medical claims analysts both use similar skills to perform their duties. Resumes from both professions include skills like "customer service," "quality standards," and "cms. "

Even though a few skill sets overlap between claims supervisors and medical claims analysts, there are some differences that are important to note. For one, a claims supervisor might have more use for skills like "corrective action," "claims adjusters," "litigation," and "claims handling." Meanwhile, some responsibilities of medical claims analysts require skills like "medical terminology," "medical insurance claims," "data entry," and "patients. "

Medical claims analysts enjoy the best pay in the insurance industry, with an average salary of $49,384. For comparison, claims supervisors earn the highest salary in the retail industry.In general, medical claims analysts hold similar degree levels compared to claims supervisors. Medical claims analysts are 0.4% more likely to earn their Master's Degree and 1.4% less likely to graduate with a Doctoral Degree.

Types of claims supervisor

Updated January 8, 2025

Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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