Team Lead – Benefit Reverification

the Opportunity • Bethesda, NC

1d • Remote

About The Position

We are seeking experienced Team Leads / Subject Matter Experts to support a large annual benefit reverification initiative for a leading healthcare and pharmaceutical patient-services organization. This is a hands-on leadership role supporting a team of approximately 20–25 Reimbursement Specialists responsible for completing annual benefit reverifications. The Team Lead will serve as a subject matter expert and day-to-day resource for the team, helping associates navigate benefit investigations, resolve reimbursement and insurance-related issues, maintain quality standards, and achieve productivity expectations. This position is ideal for someone who enjoys coaching and supporting others but is also comfortable functioning as an individual contributor. Team Leads must be willing and able to step into the work, process benefit investigations/reverifications, and assist with workload as business needs dictate. This team supports healthcare and pharmaceutical patient-service programs designed to help patients access needed therapies. The annual reverification process requires teams to validate insurance and benefit information, identify changes in coverage, resolve discrepancies, and ensure accurate reimbursement information is available to support the patient's continued access to therapy. The Team Lead plays an important role in that process by combining reimbursement expertise, hands-on production support, quality oversight, and team leadership to help a large seasonal operation successfully move cases from intake through resolution.

Requirements

• 2+ years of experience within specialty pharmacy, pharmaceutical patient services, reimbursement/HUB services, medical insurance, healthcare, a physician's office, or a related healthcare environment strongly preferred.
• Experience with benefit verification/investigation, insurance eligibility, reimbursement, patient access, prior authorization, claims, or payer processes highly desirable.
• Previous experience processing benefit investigations or reverifications in a high-volume environment is strongly preferred.
• Previous Team Lead, Supervisor, SME, Lead Reimbursement Specialist, or similar leadership experience preferred.
• Candidates without a formal leadership title may be considered if they have demonstrated experience mentoring, training, coaching, or serving as a subject matter expert for other team members.
• Experience supporting or leading a remote workforce is highly desirable.
• Bachelor's degree preferred but not required; equivalent relevant experience will be considered.
• Strong healthcare reimbursement knowledge combined with the ability to lead from within the work.
• Strong knowledge of healthcare insurance and reimbursement processes.
• Ability to research and resolve benefit investigation and payer-related issues.
• Strong coaching, mentoring, and interpersonal skills.
• Ability to balance team leadership responsibilities with individual production expectations.
• Excellent attention to detail and commitment to data and processing accuracy.
• Strong written and verbal communication skills.
• Ability to manage multiple priorities and deadlines in a high-volume environment.
• Ability to identify issues, troubleshoot problems, and appropriately escalate concerns.
• Ability to learn and navigate multiple computer systems quickly.
• Working knowledge of Microsoft Office.
• Strong judgment, accountability, adaptability, and problem-solving skills.
• Ability to motivate and support a remote team while maintaining performance expectations.

Nice To Haves

• Candidates must reside in North Carolina or South Carolina.
• Live within reasonable driving distance of Charlotte, NC.
• Be available to work Monday through Friday.
• Have flexibility to work any assigned shift falling between 8:00 AM and 8:00 PM Eastern Time.
• Be available to begin employment on November 2, 2026.
• Be available to participate in Team Lead training throughout the month of November.
• Maintain a professional and reliable work-from-home environment.

Responsibilities

• Provide day-to-day guidance and subject matter expertise to a team of approximately 20–25 Reimbursement Specialists.
• Coach team members on benefit investigations, annual reverifications, reimbursement processes, payer requirements, and issue resolution.
• Serve as a hands-on resource and individual contributor, completing reimbursement and benefit verification work when needed.
• Monitor daily productivity, work queues, quality, and completion of assigned tasks to ensure service-level expectations are achieved.
• Help associates research and resolve complex insurance, benefit, reimbursement, and patient-access issues.
• Support training and ongoing development of seasonal Reimbursement Specialists.
• Reinforce established workflows, procedures, quality standards, and client-specific requirements.
• Identify performance or workflow challenges and provide real-time coaching and support.
• Escalate complex associate, patient, payer, or operational issues to management according to established protocols.
• Assist leadership with training initiatives, job aids, process documentation, and program materials.
• Identify recurring program or process issues and recommend opportunities to improve efficiency and quality.
• Maintain open communication across the team and create a supportive, accountable remote work environment.
• Partner closely with Supervisors and Area Leadership to achieve daily and weekly program goals.
• Maintain positive and professional relationships with internal teams and external stakeholders.
• Perform additional reimbursement, operational, and leadership responsibilities as assigned.

Benefits

• We are an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, age, or any other characteristic protected by applicable law.

What This Job Offers

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