Claims Operations Lead

About the position

The Claims Operations Lead provides supervision and advanced claims processing skills for our claims operations team. The incumbent provides administrative support to facilitate the processing of a wide ranges of claims. The Claims Operations Lead will help prioritize work and ensure the team meets required service level agreements.

Responsibilities

• Serves as an initial escalation point of contact for team members who need assistance in performing work.
• Helps train new team members on claims analysis work.
• Processes claims and other document types by using case-specific procedures to verify the accuracy of claims and supporting documentation.
• Responds to email using the case-specific script provided by Case Team.
• Summarizes case and claims status, identifies issues and provides corrective action.
• Audits claims processing for accuracy.

Requirements

• GED or High School Diploma
• 3+ years in claims analysis work
• Previous leadership experience
• Basic leadership skills and ability to communicate effectively to different audiences as needed
• Proficiency with Microsoft Office Suite

Nice-to-haves

• Communication: asks questions; confirms understanding with the audience; learns and adopts best practices for written word exchanges with claimants
• Problem Solving: seeks resolution despite roadblocks; identifies alternative routes to the goal
• Critical Thinking: switches perspectives when considering solutions, to identify gaps and optimize results
• Navigates Ambiguity: works through the unknown strategically
• Organization: tracks a variety of assignments by priority, and quickly switches between tasks
• Troubleshooting: leverages systems and tools knowledge to locate and repair root causes for error
• Data Interpretation: accurately assesses claim data to drive the highest level of claimant service
• Proprietary Software: understands the underlying structure of databases and other common tools for business administration, and learns new tools rapidly
• Vision: continuously conceives of and aspires toward long-term change, while effectively executing short-term goals

Benefits

• Compensation range of 16.13 - 32.26 USD per hour
• Eligibility for an annual bonus