Healthcare Claims Team Lead — Coaching, Compliance & Process Improvement

Cognizant; Pierre (SD); Presencial; USD 60 000 - 67 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical/Dental/Vision/Life Insurance

Paid holidays + Paid Time Off

401(k) plan and contributions

Long-term/Short-term Disability

Paid Parental Leave

Employee Stock Purchase Plan

Resumo da oferta

Cognizant is seeking a Claims Team Lead in the United States to oversee daily claims operations and lead a team of claims processors/adjusters. The role focuses on maintaining productivity, quality, and adherence to client and CMS regulations while fostering team development.

Responsibilities include coaching, workload allocation to meet SLAs, and driving process improvements. The ideal candidate will have claims processing experience and leadership capabilities to support audits and performance

Qualificações

• 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.

Responsabilidades

• 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.

Conhecimentos

Leadership

Team development

Analytical thinking

Communication

Problem solving

Excel

Team leadership

Formação académica

High School Diploma or equivalent

Ferramentas

Facets

Descrição da oferta de emprego

Cognizant is seeking a Claims Team Lead in the United States to oversee daily claims operations and lead a team of claims processors/adjusters. The role focuses on maintaining productivity, quality, and adherence to client and CMS regulations while fostering team development.

Responsibilities include coaching, workload allocation to meet SLAs, and driving process improvements. The ideal candidate will have claims processing experience and leadership capabilities to support audits and performance