Claims Team Lead II

HealthEdge•Remote,

6d•$64,000 - $75,000•Remote

About The Position

UST HealthProof is looking for a Claims Team Lead, reporting to the Claims Manager. The Claims Team Lead is responsible for a team of typically 12-15 claims examiners, adjusters, extensive interaction with client organization, and multiple stakeholders. The Claims Team Lead is accountable for delivering a high-quality claims operation, meeting and exceeding all service level agreements and KPIs, driving operational excellence, and building competencies for delivery. As a Claims Team Lead at UST HealthProof, this is your opportunity to: Be responsible for directly managing a staff of typically 12 - 15 associates Be responsible for knowing and meeting client-specified guidelines Be responsible for monitoring and management of the downline staff’s productivity targets and financial and procedural accuracy standards as established by management Collaborate on special projects as assigned by the manager; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by management Establish and maintain an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality Assemble and assign projects that may include provider data, authorizations, enrolment, or other information Perform other duties as assigned by your leadership

Requirements

5+ years healthcare claims processing experience HRP
Solid understanding and ability to effectively lead a claims team
Good communication skills (verbal and written)
Microsoft application experience, especially Excel is suggested
Knowledge base of physician billing and hospital coding (ICD-10, HCPC, CPT-4), medical terminology, and authorization requirements
Willingness to learn new skills
Team collaborator
Strong work ethic

Nice To Haves

ICD-10 CPT and HCPCS coding is a plus
The ability to adapt quickly to a fast-paced environment
A self-starter and quick learner
Team player with an ability to collaborate
Ability to coach the team to reach their full potential
Dependability and the ability to work independently

Responsibilities

Directly managing a staff of typically 12 - 15 associates
Knowing and meeting client-specified guidelines
Monitoring and management of the downline staff’s productivity targets and financial and procedural accuracy standards as established by management
Collaborating on special projects as assigned by the manager; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by management
Establishing and maintaining an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality
Assembling and assigning projects that may include provider data, authorizations, enrolment, or other information
Performing other duties as assigned by your leadership