Claims Team Lead

Join us for an exciting career with the leading provider of supplemental benefits!

Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

The Claims Lead supports the Supervisor and Claims Manager in daily operations, overseeing a team of claims processors and providing technical assistance for refund and recoupment issues. Responsibilities include coordinating workflow, leading error reduction efforts, and supporting team members with claim payment procedures and accounts receivable. The Claims Lead also offers guidance on refund and recoupment adjudication, applies policies for complex benefit issues, and provides feedback on process improvements and areas of concern.

The Claims Department vision is to become the leading supplemental benefits provider, offering insurance solutions that truly work for our members. We are committed to long-term growth, both as a business and as individuals, recognizing that our people are our greatest asset and offering career development opportunities for talented professionals. Our culture is collaborative, inclusive, and rooted in integrity, with a focus on providing personalized, precision health services that promote well-being at all levels. We strive to build a best-in-class workplace where employees can thrive, ensuring a secure, healthy, and flexible environment for everyone to succeed.

The Claims Lead will monitor and assist a designated group of claims processors and provides first line technical contact for any claims refund and recoupment related issues associated with claims. Responsible for coordinating workflow, leading efforts in error reduction, and support of team members with claim payment procedures, and accounts receivable for member and providers. Provide general instruction related to refund and recoupment claim adjudication. Applies the policies and procedures as required for complex benefit issues. Provides feedback to the Supervisor, regarding refund and recoupments claims issues, process improvement opportunities and any areas of concern. Demonstrates leadership ability by encouraging positive behavior and improving efficiency.

Competencies:

• Leadership Skills: Ability to motivate, inspire, and guide a team towards achieving objectives while fostering a positive, collaborative environment.

• Communication: Strong verbal and written communication skills to clearly convey information, provide feedback, and listen to team members' concerns.

• Problem-Solving: Ability to identify issues, think critically, and implement effective solutions quickly and efficiently.

• Decision-Making: Demonstrates sound judgment when making decisions, balancing team needs and organizational goals.

• Conflict Resolution: Skilled in addressing conflicts within the team, mediating disputes, and ensuring a harmonious work environment.

• Time Management: Effective …