Claims Team Leader

Job not on LinkedIn

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $50.8k - $81.3k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 20%

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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PACIFICSOURCE

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

Not-for-profit health plans

📋 Description

• Supervise, coach, train, evaluate, and provide leadership to Claims Analysts and support staff • Manage claims production and quality to meet department and company standards • Resolve claims adjudication issues • Hire, train, coach, counsel, and evaluate team member performance • Oversee and assist with medical and dental claims review, research, coverage determinations, and dispute resolution • Communicate business process and procedure changes to team members • Coordinate initial and continued education with the department Training Coordinator • Oversee responses to mail and email inquiries, write business letters, and prepare reports • Participate in interoffice, strategic, internal, and departmental committees and workgroups • Support cross-team communication, collaboration, and claims-processing efficiency • Follow PacificSource privacy policies and HIPAA requirements • Maintain collaborative partnerships with key departments • Assist with process improvement using lean methodologies, visual boards, daily huddles, and KPI monitoring • Participate in department meetings and team visual-board huddles • Meet department and company performance and attendance expectations • Perform other duties as assigned

🎯 Requirements

• Minimum of 3 years of experience in a closely related insurance field or 3 years of supervisory experience • High school diploma or equivalent • Thorough understanding of claims processing systems and operations • Basic working knowledge of Oregon Insurance Division rules and regulations • Advanced PC skills, including Microsoft Word and Excel • Accurate typing, 10-key pad, multi-line telephone system, and fax machine operation • Research skills and ability to evaluate claims for accurate auditing • Advanced skills in medical terminology and CPT / ICD-10 coding • Ability to read and comprehend written and spoken English • Ability to communicate clearly and effectively • Ability to work under time pressures and deal with difficult situations • Approximately 5% travel required

🏖️ Benefits

• Equal opportunity employment • Ergonomically configured equipment • Professional training and continued education opportunities • Collaborative workgroups, committees, and leadership peer groups • Work-from-home arrangement • Approximately 5% travel