Claims Review Supervisor/Expert

Position Information

Job Series: Program Operations – Claims Review

Classification: Claims Review Supervisor / Expert

Class Code: PCR03P

Pay Grade: SGS06

Salary Range: $52,137 – $77,163

Job Summary

Primary Responsibilities

Knowledge and Skills

Minimum Qualifications

Bachelor’s degree in a relevant field, such as business administration, finance, insurance, risk management, or healthcare administration.

Minimum of 4 years of experience in claims review, analysis, or a related field within the insurance or financial services industry.

Demonstrated expertise in handling complex claims and a proven track record of high-level decision-making.

Experience in a specialized claims sector, such as healthcare, property and casualty, or workers’ compensation may be required.

Professional certifications such as Associate in Claims (AIC), Certified Professional Claims Analyst (CPCA), or Chartered Property Casualty Underwriter (CPCU) may be required.

Satisfaction of the minimum qualifications, including years of experience and service, does not entitle employees to automatic progression within the job series. Promotion to the next classification level is at the discretion of the department and the Office of Personnel Management, taking into consideration the employee’s demonstrated skills, competencies, performance, workload responsibilities, and organizational needs.

Licensure/Certifications