Claims Team Lead - Drive Resolution & Process Excellence

Texas Children's; Bellaire (TX); On-site; USD 65,000 - 85,000; Full time

Job summary

Texas Children's is seeking a Claims Supervisor to lead a team of Claims Examiners and Claims Benefits Specialists in an environment guided by HEART values. The role focuses on timely resolution of complex claims issues through leadership, coaching, and performance monitoring.

You will manage daily workflows, review production metrics, and drive improvements across claims processing to ensure accuracy and efficiency in claims handling.

Qualifications

• High school diploma or GED is required.
• Minimum 5 years of claims processing experience.

Responsibilities

• Proactively identifies and solves problems with timely resolution of complex issues referred by Claims Examiners and Claims Benefits Specialists
• Provides daily management support to Claims Examiners and Claims Benefits Specialists
• Obtains daily stats of each team member's production goals to review with Manager, and develops a plan to increase production while maintaining accuracy
• Responds to a claims processing question rapidly and accurately to meet expectations of timely processing of claims in queue via email or discussion
• Monitors and audits criteria based on claims training to ensure understanding of policy and procedures
• Assists the Manager with conducting performance reviews and team meetings
• Identifies opportunities for process and service improvement initiatives and participates in action plan development and implementation
• Compiles and reviews internal reports to identify any incorrect claims payment for all product lines for weekly check run
• Serves as initial point of contact for all issues regarding work schedules

Education

High school diploma or GED

Job description

Texas Children's is seeking a Claims Supervisor to lead a team of Claims Examiners and Claims Benefits Specialists in an environment guided by HEART values. The role focuses on timely resolution of complex claims issues through leadership, coaching, and performance monitoring.

You will manage daily workflows, review production metrics, and drive improvements across claims processing to ensure accuracy and efficiency in claims handling.