Claims and Finance Lead - Washington, DC - Onsite

Gainwell Technologies LLC•Washington, DC

61d•$35,900 - $51,300•Onsite

About The Position

The Senior Claims Resolution & Finance Team Lead is a key leadership role responsible for overseeing end‑to‑end claims management operations, financial accuracy, and process optimization within the claims resolution function. This role manages a team of analysts and specialists focused on timely claim adjudication, dispute resolution, financial reconciliation, and compliance with internal policies and external regulations. The Senior Team Lead acts as an operational expert, strategic partner, and coach—driving performance, ensuring quality, and advancing continuous improvement initiatives.

Requirements

Bachelor’s degree (or equivalent experience) in Business, Finance, Accounting, Healthcare Administration, or a related field
5–7+ years in claims resolution, financial operations, or related roles
2–3+ years of leadership experience
Proven knowledge of claims workflows, financial reconciliation, and analytical problem-solving
High proficiency with claims management systems and MS Office
Strong skills in coaching, stakeholder management, communication, and negotiation to lead and develop high-performing teams
Experience in BPO, healthcare, insurance, or shared services operations
Familiarity with relevant regulatory environments (e.g., CMS, insurance compliance)
Operational excellence, process optimization, quality assurance, analytical thinking, conflict resolution, and strategic decision-making.

Responsibilities

Lead, mentor, and coach claims resolution and finance teams; oversee workload, staffing, and training to achieve performance, quality, and accuracy goals.
Manage the full claims lifecycle, resolving complex cases, establishing standards for turnaround time, accuracy, and service excellence.
Oversee financial processes including payments, reimbursements, adjustments, and reconciliations; review reports and address discrepancies or process gaps.
Analyze workflows and metrics to identify inefficiencies; partner with IT, compliance, and finance teams to optimize processes and implement best practices.
Collaborate with internal partners across Finance, Operations, Legal, and Customer Support; ensure regulatory compliance, monitor internal controls, and serve as subject matter expert for claims and financial processes.