Claims Team Lead

🔥 1 minute ago

🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟠 Senior

👻 Ghost score 10%

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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Health Admins

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2015

💼 Consulting

🛡️ Insurance

📣 Marketing

Consulting • Insurance • Marketing

Health Admins is leading healthcare in a new direction by simplifying access to healthcare services and making them more affordable for members. Through their Smart Healthcare Platform, they provide TPA software, healthcare navigation, bill negotiation, and claims processing services. Their goal is to enhance member satisfaction and foster loyalty by offering powerful tools and personalized assistance to control costs and improve healthcare decisions.

📋 Description

• Lead a team of 4–7 Claims Processors and Senior Claims Processors • Provide ongoing support, answer questions, and guide staff through complex or escalated cases • Oversee daily claims processing, including reviewing medical invoices and processing payments according to guidelines and deadlines • Resolve escalated issues and disputes with members and providers • Train, coach, and provide feedback to new and junior staff • Monitor department performance and track KPIs with Management • Implement process improvements and coordinate with various departments • Identify inefficiencies and recommend automation, system enhancements, or procedural changes • Maintain accurate member records in the CRM system and conduct periodic claims audits • Communicate directly with members and manage queries and escalations professionally, empathetically, and accurately

🎯 Requirements

• Bachelor's degree or equivalent experience in a related field • 2–3 years of experience in healthcare, claims processing, or a related field • 1–2 years of leadership experience • Experience in process improvement, team management, or case management is preferred • Experience with CRM systems, such as Salesforce, is a plus • Strong leadership skills with the ability to manage and motivate a team • Advanced knowledge of medical terminology, claims processing, and medical billing practices • Proficiency in working independently and collaboratively within a fast-paced, team environment • Exceptional communication skills with a customer-centric mindset • High level of attention to detail, accuracy in documentation, and data entry • Critical thinking and problem-solving skills, especially when resolving escalated issues • Ability to multitask and adapt to changing priorities efficiently • Familiarity with claims management software and medical billing processes • Proficient in using Google Suite and CRM systems (Salesforce preferred)

🏖️ Benefits

• Competitive salary and benefits package • Dynamic and innovative work environment • Opportunities for professional growth and development • Remote work flexibility