Healthcare Claims Lead: Operations & Quality

Cognizant; Olympia (WA); In loco; USD 60.000 - 67.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical/Dental/Vision/Life Insurance

Paid holidays and PTO

401(k) plan

Disability insurance

Paid Parental Leave

Employee Stock Purchase Plan

Descrizione del lavoro

Cognizant is seeking a Claims Team Lead in the United States to oversee daily claims operations and support a team of processors/adjusters. You will drive productivity, quality, and compliance while guiding staff development and process improvements.

The role requires leadership experience, claims expertise across lines (Commercial/Medicare/Medicaid), and proficiency with Facets and Excel. Strong communication and problem-solving skills are essential.

Competenze

• High School Diploma or equivalent required.
• Healthcare claims processing experience (Commercial, Medicare, Medicaid, or related lines).
• Experience with claims platforms: Facets.
• Strong knowledge of claim adjudication, adjustments, appeals, and regulatory requirements.
• Lead, mentoring, or supervisory experience preferred.
• Strong analytical, communication, and problem-solving skills.
• Proficiency with Microsoft Office, especially Excel.
• Experience leading a team.

Mansioni

• Provide day-to-day leadership and support to claims associates.
• Monitor productivity, quality, accuracy, and turnaround time performance.
• Conduct coaching, training, and performance discussions.
• Review inventories and allocate workload to meet SLAs.
• Identify process improvement and automation opportunities.
• Ensure adherence to client policies, CMS/regulatory requirements, and internal procedures.
• Handle escalated claims and operational issues.
• Support audits, quality reviews, and corrective action plans.
• Prepare operational reports and communicate performance results to leadership.
• Partner with training, quality, and client teams to drive improvements.

Conoscenze

Leadership

Team leadership

Analytical thinking

Communication

Problem solving

Regulatory knowledge

Formazione

High School Diploma or equivalent

Strumenti

Facets

Excel

Descrizione del lavoro

Cognizant is seeking a Claims Team Lead in the United States to oversee daily claims operations and support a team of processors/adjusters. You will drive productivity, quality, and compliance while guiding staff development and process improvements.

The role requires leadership experience, claims expertise across lines (Commercial/Medicare/Medicaid), and proficiency with Facets and Excel. Strong communication and problem-solving skills are essential.