Claims Supervisor

About the Role

Baraya Extended Care is seeking a Claims Supervisor to lead the daily operations of its insurance claims workflow in Riyadh, Saudi Arabia. This full-time role focuses on ensuring accurate claim submission, timely adjudication, and effective denial management. The Claims Supervisor will guide a team of claims specialists, collaborate with payers, and monitor performance to maximize clean claim rates, minimize denials, and optimize cash collections.

Role Scope and Impact

The Claims Supervisor oversees the end-to-end lifecycle of insurance claims, including pre-billing validation, claim submission, payment posting, denial analysis, and appeal coordination. This position works closely with Revenue Cycle leadership to standardize claim workflows, enforce internal controls, and track key performance indicators to improve cash flow and reduce days in accounts receivable. The supervisor will provide day-to-day supervision to claims staff, offer performance coaching, and resolve complex payer issues, coordinating with Payer Relations, IT, Compliance, and Finance to implement system enhancements and ensure accurate reporting. The role supports training, workload balancing, and staffing plans, and may manage relationships with outsourcing vendors or third-party billing partners. A strong focus on accuracy, compliance (HIPAA, CMS guidelines, payer contracts), and customer service is essential.

Key Responsibilities

• Lead daily insurance claims operations to ensure timely submission and accurate adjudication.
• Develop and enforce standardized claim workflows, policies, and internal controls.
• Monitor and report on key metrics; drive improvements in denial management and cash flow.
• Supervise claims staff; provide coaching, performance feedback, and professional development.
• Collaborate with RCM leadership, Payer Relations, IT, Compliance, and Finance to resolve issues and optimize systems.
• Oversee pre-billing validation, claims submission, payment posting, denial analysis, and appeals coordination.
• Track metrics such as gross and net days in A/R, denial rate, clean claim rate, posting accuracy, and average days to resolution.
• Conduct regular audits of claim submissions and denial reasons; implement corrective actions.
• Manage payer communications, negotiate where appropriate, and escalate payer performance issues.
• Lead process improvement initiatives to reduce denials and accelerate reimbursement.
• Ensure integrity of EHR/billing system data, coding alignment, and security controls.
• Provide training and supervision for frontline claims staff; manage workload and scheduling.
• Prepare performance dashboards and variance analyses for leadership.
• Maintain compliance with applicable laws, regulations, and internal policies.

Qualifications and Experience

• 5-10 years of experience in insurance claims or revenue cycle management.
• Demonstrated leadership experience in managing claims operations and staff.
• Strong understanding of insurance claim submission, adjudication, and denial management processes.
• Knowledge of HIPAA, CMS guidelines, and payer contracts.
• Proficiency in EHR/billing systems and data integrity.

Work Environment

This is a full-time position based in Riyadh, Saudi Arabia, requiring on-site presence to lead and supervise the claims team and operations effectively.

Application Process

Interested candidates are invited to apply. Salary details will be discussed during the interview process.