Claims Appeals Team Lead - Onsite - West Sacramento, CA
About The Position
The Claims Appeals Team Lead performs complex standard and non-standard processing and quality tasks in support of outsourced services within a specific industry and functional area. The role applies knowledge of the client’s business and market dynamics to support best practices and continuous process improvement, and identifies issues and recommends or implements approved changes to procedures and workflows. The position analyzes, interprets, audits, and reconciles reports for accuracy and completeness; maintains pertinent records; prepares standard and ad hoc reports; and researches problems and follows up with clients on resolution. It interfaces with management and clients to resolve issues, supports the development and documentation of standard operating procedures, and handles confidential company data in accordance with applicable policies and security procedures. The Team Lead may guide less experienced personnel, train and assist team members, monitor employees’ daily work for adherence to policies and procedures, coordinate scheduling, and prioritize and delegate work. The position is based in an office environment in West Sacramento, California.
Requirements
- High school diploma or GED.
- Six or more years of experience with business process service delivery and improvement, preferably in an outsourcing environment.
- Experience working with the client company’s products and/or services.
- Experience working with the client company’s industry and/or functional area.
- Experience working with business solutions software.
- Strong communication skills.
- Strong personal computer and business solutions software skills.
- Strong organization and time management skills.
- Good problem-solving skills.
- Team leadership skills to train and assist less experienced personnel.
- Ability to multitask.
- Ability to work independently and as part of a team.
- Ability to assess clients’ businesses and identify improvement opportunities.
Responsibilities
- Perform complex standard and non-standard processing and quality tasks supporting outsourced services.
- Apply knowledge of the client’s business and market dynamics to ensure best practices and continuous process improvement.
- Identify issues and review, recommend, and implement approved modifications to procedures and workflows.
- Analyze work and report findings; interpret, audit, and reconcile reports for accuracy or completeness.
- Maintain logs of pertinent data and provide periodic status reports.
- Prepare standard and ad hoc reports for management and clients.
- Research problems and follow up with clients regarding resolution.
- Interface with management and clients to resolve issues and assist with implementing approved resolutions.
- Support development and documentation of new or revised standard operating procedures.
- Handle confidential company data according to policy and security guidelines.
- Provide leadership and work guidance to less experienced personnel, as needed.
- Train and assist team members and monitor daily employee activity for adherence to policies and procedures.
- Coordinate with managers and employees to ensure adequate scheduling.
- Prioritize and delegate work.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
