CLAIMS REVIEW SUPERVISOR/EXPERT

Date: Jul 7, 2026

Req ID: 58322

Location:

Statewide, AR, US, 72202

Category: DEPT OF WORKFORCE SERVICES

Anticipated Starting Salary: $52,137.07

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

The Claims Review Supervisor / Expert is a senior-level professional responsible for overseeing the evaluation and processing of complex insurance claims. Leveraging their in-depth knowledge and extensive experience, they ensure claims are handled with accuracy, efficiency, and in compliance with pre-determined agency policies and legal regulations. This role requires advanced analytical capabilities to assess high-value or intricate claims, mentor junior team members, and drive strategic improvements in claims management processes. The Claims Review Supervisor / Expert is pivotal in maintaining organizational integrity, reducing risk, and enhancing customer trust.

Primary Responsibilities

The assignment of supervisory duties is determined by the hiring agency's operational needs. Non-supervisory roles will serve as senior technical experts. Conduct comprehensive reviews of complex, high-value, or specialized claims to determine eligibility and validity. Provide guidance and resolution for escalated claims that require expert analysis and decision-making. Collaborate with internal personnel, external personnel, and legal teams in an attempt to resolve disputes and ensure compliance with regulations. Design and implement process improvements in an attempt to optimize claims handling efficiency and accuracy. Lead or contribute to fraud detection initiatives by identifying patterns and assessing claims for potential fraudulent activity. Serve as a subject matter expert and mentor for junior claims analysts, providing training, support, and development opportunities. Stay abreast of industry trends, regulatory changes, and best practices to ensure claims processes align with current standards. Generate detailed reports and present data-driven insights to senior management to guide policy adjustments or operational decisions.

Knowledge and Skills

Advanced analytical skills and attention to detail. Strong leadership and mentoring abilities. Proficient in claims management systems and tools. Excellent written and verbal communication skills. Sound knowledge of relevant legal and regulatory frameworks.

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

N/A OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.