The National Health Insurance invites qualified and professional applicants to apply for the post of Claims Supervisor.
The Claims Supervisor is responsible for the direct supervision and operational oversight of the Claims Unit. The position ensures that claims are adjudicated accurately, consistently, and in compliance with the NHI Regulations, approved Benefit Package, internal policies, and established processing guidelines.
Essential Functions
- Supervise the daily activities of Claims Processors.
- Assign workloads and monitor turnaround times.
- Ensure claims are processed accurately and within established timelines.
- Review complex, high-value, or exception claims before final determination when required.
- Ensure consistent application of benefit schedules and coverage policies.
- Conduct periodic quality reviews of processed claims.
- Monitor adherence to NHI Regulations, benefit guidelines, and internal procedures.
- Identify and report trends, irregularities, or risk indicators to the Manager.
- Investigate discrepancies related to claims payments.
- Support internal and external audit requests related to claims operations.
- Prepare weekly and monthly statistical reports.
- Monitor claims volume, denial trends, and productivity metrics.
- Provide data and operational insights to the Manager.
- Track continued claims and ensure timely follow-up on required documentation.
- Liaise with Accounts Department to authorize payment of approved claims.
- Ensure proper reconciliation of approved claims and payment outputs.
- Escalate system errors or configuration issues to IT.
- Assist in testing system updates affecting claims processing.
- Provide guidance, coaching, and technical support to Claims Processors.
- Conduct performance evaluations in collaboration with the Manager.
- Identify training needs related to coding, billing, and benefit interpretation.
- Promote accountability and professionalism within the unit
- Performs other duties or special projects as required or as assigned by a supervisor.
Requirements of the position:
A) Education
Required Education: Bachelor’s Degree
PLUS
Field of study: Health Administration, Insurance, or related field with at least five (5) years’ experience in claims processing, including supervisory experience
Work Experience: Minimum of 5 years in related field
Knowledge/Skills/Abilities
- Strong knowledge of Microsoft Suite (Word, Excel, PowerPoint, Outlook).
- Comfortable in a fast-paced environment with frequent deadlines; high energy, self-motivated and proactive.
- Ability to multitask, and be flexible with regard to workload and assignments.
- Ability to exercise judgment.
- Excellent interpersonal and communication skills to work with staff and customers at a wide range of levels.
- Strong written and verbal communication skills.
- Attention to detail and commitment to excellence demonstrated by the delivery of quality and timely outcomes.
- Ability to work both independently and as an effective team member in a team environment.
Application Reference # – NHI-EXT-2026-02
Please send Resume/CV, cover letter and (two) 2 professional references to the:
Human Resources Manager
Social Security Board
P.O. Box 698
Road Town, Tortola
Virgin Islands
VG1110
[email protected]
Closing Date: March 13th, 2026
