Claims Processing Lead: Team Manager & Excellence

Florida Blue; San Antonio (TX); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health insurance

Life insurance

Disability (short/long-term)

401(k) retirement plan

Paid time off

11 holidays

Wellness program

Job summary

WebTPA, a GuideWell Company, is seeking an Assistant Manager of Claims Processing to lead a team of Claims Examiners responsible for daily claims processing and issue resolution. The role requires oversight of priorities, mentoring staff, and ensuring quality and deadlines are met.

The position emphasizes supervision, collaboration with HR and Talent Acquisition, and continuous process improvement within a healthcare benefits environment.

Qualifications

• 2+ years related work experience as a claims examiner or adjudication experience on a computerized claims payment system in the healthcare industry.
• 1+ years direct supervisory/management experience
• Bachelor's degree or related equivalent work experience
• Proven judgment and analytical thinking abilities
• Strong written and oral communication skills

Responsibilities

• Lead a team of Claims Examiners and serve as SME for processing questions.
• Hire, onboard, and train new staff with Talent Acquisition and HR processes.
• Manage claims processing priorities, deadlines, and performance metrics.
• Review quality metrics with Internal Audit and escalate areas for improvement.
• Coach team members and conduct performance appraisals.
• Oversee timekeeping, PTO requests, and disciplinary actions as needed.
• Perform claims testing for benefits changes, renewals, and new groups.

Skills

2+ years experience

Supervisory experience

Analytical thinking

Communication skills

Education

Bachelor's degree or related equivalent

Tools

MS Office

WebTPA systems

Job description

WebTPA, a GuideWell Company, is seeking an Assistant Manager of Claims Processing to lead a team of Claims Examiners responsible for daily claims processing and issue resolution. The role requires oversight of priorities, mentoring staff, and ensuring quality and deadlines are met.

The position emphasizes supervision, collaboration with HR and Talent Acquisition, and continuous process improvement within a healthcare benefits environment.