Healthcare Claims Team Lead

Cognizant; Montpelier (VT); On-site; USD 60,000 - 67,000; Full time

Benefits offered by this job

Medical/Dental/Vision/Life Insurance

Paid holidays plus Paid Time Off

401(k) plan and contributions

Long‑term/Short‑term Disability

Paid Parental Leave

Employee Stock Purchase Plan

Job summary

Cognizant seeks a Claims Team Lead to oversee daily claims operations in a fast-paced environment, guiding processors and adjusters while maintaining high productivity and quality.

You will act as the first escalation level for operational issues and drive compliance with client, regulatory, and internal standards.

Qualifications

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

Responsibilities

• 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.

Skills

Leadership

Coaching and mentoring

Analytical skills

Communication skills

Problem solving

Microsoft Excel

Team management

Regulatory knowledge

Education

High School Diploma or equivalent

Tools

Facets

Job description

The Claims Team Lead is responsible for overseeing daily claims operations, supporting a team of claims processors/adjusters, ensuring productivity and quality goals are met, and serving as the first level of escalation for operational issues. The role drives compliance with client, regulatory, and organizational requirements while fostering employee development and continuous improvement.

Key Responsibilities

• 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.

Qualifications

• At least a High School Diploma or equivalent is required

• Healthcare claims processing experience (Commercial, Medicare, Medicaid, or related lines of business).

• Experience with claims platforms: Facets

• Strong knowledge of claim adjudication, adjustments, appeals, and regulatory requirements.

• Previous lead, mentoring, or supervisory experience preferred.

• Strong analytical, communication, and problem-solving skills.

• Proficiency with Microsoft Office, especially Excel.

• Experience leading a team

Key Competencies

• Leadership and team development

• Performance management

• Client focus

• Operational excellence

• Quality and compliance management

• Process improvement

• Decision‑making and problem solving

Salary and Other Compensation

The annual salary for this position is between $60,000 - $67,000 depending on experience and other qualifications of the successful candidate.

This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant’s applicable plans.

Benefits

Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

• Medical/Dental/Vision/Life Insurance

• Paid holidays plus Paid Time Off

• 401(k) plan and contributions

• Long‑term/Short‑term Disability

• Paid Parental Leave

• Employee Stock Purchase Plan

Disclaimer

The salary, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.