Team Leader – Claims

🔥 21 hours ago

🇺🇸 United States – Remote

💵 $25 - $31 / hour

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Arkansas Blue Cross and Blue Shield

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1948

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Arkansas Blue Cross and Blue Shield is a health insurance provider licensed to offer health plans in all 75 counties of Arkansas. The company offers a wide range of insurance products including individual and family plans, Medicare and Medigap plans, dental and vision plans, as well as health plans for travelers and employer group plans. They provide members with personalized services such as health management through the Blueprint Portal, where users can manage their health plan, review claims, find healthcare providers, and estimate treatment costs. Arkansas Blue Cross and Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association.

📋 Description

• Ensure timely and accurate claims processing by monitoring and analyzing Claims Specialists' workflow • Handle difficult and sensitive situations and escalate issues to the supervisor as necessary • Make decisions within the limits of plan documents and company policies • Request exceptions or appropriate authority review when unusual situations arise and the supervisor is unavailable • Maintain a positive and productive work environment in the absence of a supervisor • Work with Claims Trainers to ensure appropriate and consistent initial and ongoing employee training • Assist the supervisor during interviews for new employees • Mentor team members and provide assistance with work-related functions • Provide feedback and coaching regarding performance and quality standards • Foster teamwork and maintain working relationships with management and staff in supporting departments • Analyze claims workflow to identify trends requiring attention • Review processes, identify training and development needs, and enhance individual team-member workflow • Monitor claims for accuracy and timely processing • Answer customer-related inquiries and process pended claims as needed • Perform other duties as assigned

🎯 Requirements

• High School diploma or equivalent • Minimum two (2) years' claims processing or customer service experience • Demonstrates above average production, quality standards and dependability as specified by the functional area • Detailed knowledge about all ABCBS health insurance plans and/or groups supported by the team, including expertise in benefit and claims processing guidelines preferred • Oral & Written Communication • Strong Interpersonal skills • Sound Judgement • Decision Making • Detail-Oriented • Teamwork • Dependability • Keyboarding • Computer Literacy • Taking Initiative • Peer Mentoring • Demonstrated ability to successfully assist with special requests and/or projects