Claims Team Lead - Appeals & Resolution Expert

Careington International Corp.; Frisco (TX); Hybrid; USD 65,000 - 95,000; Full time

Job summary

Careington International is seeking a Claims Specialist Team Lead to oversee the Claims department, resolve escalated issues, and mentor a team. This hybrid role requires attendance at the Frisco, TX office three days per week with a path to full onsite in 2027.

You will manage appeals, review complex claims, train specialists, and report trends to leadership while ensuring timely handling in line with client and regulatory timeframes.

Qualifications

• Highly organized with the ability to manage multiple tasks and deadlines.
• Experience interpreting client plan documents, claims research, and letter writing.
• Proficient with Microsoft Office apps; able to learn Careington systems quickly.

Responsibilities

• Manage escalated issues, complaints, and appeals to resolution.
• Assist Claims Manager with questions from Claims Specialists.
• Assist with training for Claims Specialists.
• Identify trends and emerging issues; report root causes to leadership.
• Review and analyze complex appeals; ensure timely handling per timeframes.
• Provide feedback to leaders for coaching and mentoring team members.

Skills

Highly organized

Independent worker

Deadline-driven

Strong communicator

Education

Associate degree or equivalent combination of education and experience

Tools

Adobe

Excel

Word

Outlook

Job description

Careington International is seeking a Claims Specialist Team Lead to oversee the Claims department, resolve escalated issues, and mentor a team. This hybrid role requires attendance at the Frisco, TX office three days per week with a path to full onsite in 2027.

You will manage appeals, review complex claims, train specialists, and report trends to leadership while ensuring timely handling in line with client and regulatory timeframes.