[Hiring] Claims Team Lead II @HealthEdge

Role Description

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 and adjusters.
• Extensive interaction with client organizations 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.
• 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.
• Know and meet client-specified guidelines.
• Monitor and manage 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, which 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, enrollment, or other information.
• Perform other duties as assigned by your leadership.

Qualifications

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

Requirements

• 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.

Benefits

• Remote work opportunity.
• Full-time, permanent employment.
• Annual US base salary range for this position is $64,000 to $75,000.

Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:

• Occasionally required to move around the office.
• Specific vision abilities required include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
• Work across multiple time zones in a hybrid or remote work environment.
• Long periods of time sitting and/or standing in front of a computer using video technology.
• May require travel dependent on company needs.

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990.

Candidates may be required to go through a pre-employment criminal background check. HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans, and persons with disabilities.