Healthcare Claims Team Lead – Remote

ImagenetLLC • Jacksonville, NC

1d • $22 - $25 • Remote

About The Position

We are seeking a highly driven Team Lead – U.S. Claims (Implementation Focus) to play a critical role in launching and supporting a new client engagement. This position is ideal for a hands-on leader who thrives in fast-paced environments and enjoys building processes from the ground up.

You will lead end-to-end implementation efforts while ensuring operational readiness, cross-functional alignment, and a successful go-live. In addition to standard Team Lead responsibilities, this role requires active involvement in implementation, process design, and client onboarding.

Requirements

• Min. 5 years of experience processing easy, moderate, and complex medical claims (payer-side experience preferred)
• 2+ years in a leadership role within claims or healthcare operations.
• Proven experience in implementations, transitions, or new client launches
• Strong experience with Medicare and Medi-Cal claims, including a working knowledge of CMS guidelines and regulatory requirements.
• Prior quality assurance and training experience with demonstrated ability to identify trends
• Previous experience leading, coaching, or mentoring teams in a claims or healthcare operations environment.
• Strong analytical skills with the ability to interpret performance data and KPIs.
• Excellent communication, organizational, and decision-making skills.
• High attention to detail and commitment to accuracy, compliance, and operational excellence.

Responsibilities

• Lead end-to-end client implementation, from discovery through go-live and stabilization
• Translate client requirements into operational workflows, SOPs, and staffing models
• Develop and execute detailed implementation plans, including timelines and milestones
• Identify risks early and proactively drive mitigation strategies
• Partner with Training, QA, IT, and Workforce Management teams to ensure readiness across all workstreams
• Coordinate system setup, user acceptance testing (UAT), and access provisioning with IT and client teams
• Ensure all systems, tools, and environments are fully tested and production-ready prior to go-live
• Support development of process documentation, job aids, and knowledge base materials
• Validate workflows for claims processing, including escalation paths and exception handling
• Ensure processes are scalable, efficient, and aligned with client expectations
• Perform standard Team Lead responsibilities including team oversight, performance management, and reporting
• Take ownership of Quality Assurance and Training functions during the implementation phase
• Provide hands-on support in building, testing, and executing processes

Benefits

• Remote work offered
• Equipment provided
• Paid training to set you up for success
• Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
• Paid Time Off (PTO)
• 7 paid holidays
• A supportive team and a company that values internal growth

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed