[Hiring] Healthcare Claims Team Lead @ImagenetLLC

Role Description

We are seeking a highly driven Healthcare Claims Team Lead 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.

• Lead end-to-end implementation efforts while ensuring operational readiness, cross-functional alignment, and a successful go-live.
• Active involvement in implementation, process design, and client onboarding.

Key Responsibilities

• Implementation & Client Onboarding
  • 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.
• Cross-Functional Coordination
  • 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.
• Operational Readiness & Process Design
  • 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.
• Expanded Leadership Scope
  • 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.

Qualifications

• 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.

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.

Company Description

Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication, and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.

• The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement, and satisfaction with plans’ members and providers.
• The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually.
• The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance, and automation of claims operations for its clients.
• Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S., and has a wholly owned global delivery center in the Philippines.