Claims Team Lead

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $44k - $50k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

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HealthEdge

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2005

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

📋 Description

• Report to the Claims Manager • Directly manage typically 12–15 claims examiners and adjusters • Know and meet client-specified guidelines • Monitor and manage downline staff productivity targets and financial and procedural accuracy standards • Collaborate on special projects, including process documentation, training, quality audits, and surge activity for clients • Maintain communication with management to address issues and ensure processing accuracy and quality • Assemble and assign projects involving provider data, authorizations, enrollment, or other information • Perform other duties as assigned by leadership

🎯 Requirements

• 5+ years healthcare claims processing experience • Solid understanding and ability to effectively lead a claims team • Good verbal and written communication skills • Microsoft application experience, especially Excel suggested • ICD-10, CPT, and HCPCS coding is a plus • Knowledge of physician billing and hospital coding (ICD-10, HCPC, CPT-4), medical terminology, and authorization requirements • Willingness to learn new skills • Team collaboration • Strong work ethic • Ability to adapt quickly to a fast-paced environment • Self-starter and quick learner • Ability to coach the team to reach their full potential • Dependability and ability to work independently • May be required to pass a pre-employment criminal background check

🏖️ Benefits

• Remote work environment • May require travel dependent on company needs • Reasonable accommodations for individuals with disabilities • Equal opportunity employer and workforce diversity commitment