Claims Team Lead: Elevate Quality & Service

PacificSource; Springfield (OR); On-site; USD 51,000 - 81,000; Full time

Job summary

PacificSource is seeking a Claims Supervisor to lead and develop the Claims Analysts and support staff in Oregon. You will supervise operations, ensure accurate claims processing, and drive performance improvements while upholding HIPAA and privacy standards.

Responsibilities include evaluating staff, coaching, and coordinating with training, quality, and compliance teams to deliver exceptional service to members and providers. 5% travel may be required.

Qualifications

• Minimum of 3 years of experience in closely related insurance field or 3 years of supervisory experience.
• Ability to understand PacificSource products, provider relationships, and health insurance terminology.
• Strong leadership and coaching abilities to guide staff and improve performance.
• Knowledge of claims processing systems and CPT/ICD-10 terminology.

Responsibilities

• Provide supervision, coaching, training, evaluation and leadership to assigned staff.
• Assure claims processing, production and quality meet department and company standards.
• Evaluate performance of team members.
• Analyze results of performance reports to determine training needs.
• Oversee claims processing service to members, providers and employers.
• Interpret benefits and policy provisions accurately.
• Review and research medical and dental claims to determine coverage.
• Investigate and settle claims issues as needed.
• Communicate process changes to the team in a timely manner.
• Coordinate with Training Coordinator for staff education.
• Participate in department meetings and committees, and report back to leadership.

Skills

Leadership

Coaching

Communication

Critical Thinking

Decision Making

Team Collaboration

Organizational Skills

Education

High School Diploma

Tools

Microsoft Word

Microsoft Excel

Job description

PacificSource is seeking a Claims Supervisor to lead and develop the Claims Analysts and support staff in Oregon. You will supervise operations, ensure accurate claims processing, and drive performance improvements while upholding HIPAA and privacy standards.

Responsibilities include evaluating staff, coaching, and coordinating with training, quality, and compliance teams to deliver exceptional service to members and providers. 5% travel may be required.