Claims Team Lead

🔥 1 hour ago

🇺🇸 United States – Remote

💵 $44k - $50k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• Directly manage a staff of typically 12–15 associates • Know and meet client-specified guidelines • Monitor and manage downline staff productivity targets and financial and procedural accuracy standards • Collaborate on manager-assigned special projects, including process documentation, training, quality audits, and surge activity support • Maintain communication with management to address issues, concerns, and preventive measures ensuring processing accuracy and quality • Assemble and assign projects involving provider data, authorizations, enrollment, or other information • Deliver a high-quality claims operation while meeting or exceeding service level agreements and KPIs • Drive operational excellence and build competencies for delivery • Perform other duties 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) • Knowledge of 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 collaborate as a team player • Ability to coach the team to reach its full potential • Dependability and ability to work independently • May be required to undergo a pre-employment criminal background check

🏖️ Benefits

• Remote work environment • Work across multiple time zones • May require travel dependent on company needs • Reasonable accommodations for individuals with disabilities • Equal opportunity and workforce diversity commitment