Healthcare Claims Team Lead - Lead & Optimize Claims Ops

Cognizant; Richmond (VA); On-site; USD 60,000 - 67,000; Full time

Benefits offered by this job

Medical/Dental/Vision/Life Insurance

Paid holidays plus PTO

401(k) plan and contributions

Disability (Long-term/Short-term)

Paid Parental Leave

Employee Stock Purchase Plan

Job summary

Cognizant is seeking a Claims Team Lead to oversee daily claims operations and coach a team of claims processors/adjusters. The role focuses on productivity, quality, and timely adjudication while ensuring compliance with client, CMS/regulatory standards, and internal procedures.

The position emphasizes leadership, process improvement, and collaboration with training and client teams to drive continuous improvement. Extensive healthcare claims experience and strong Excel skills are required.

Qualifications

• 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.
• 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

Claims processing experience

Analytical skills

Communication skills

Problem solving

Leadership

Education

High School Diploma

Tools

Facets

Microsoft Excel

Job description

Cognizant is seeking a Claims Team Lead to oversee daily claims operations and coach a team of claims processors/adjusters. The role focuses on productivity, quality, and timely adjudication while ensuring compliance with client, CMS/regulatory standards, and internal procedures.

The position emphasizes leadership, process improvement, and collaboration with training and client teams to drive continuous improvement. Extensive healthcare claims experience and strong Excel skills are required.