Medical Claims Team Lead - Hybrid

Moda Health; Portland (OR); Hybrid; USD 60,000 - 75,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Pharmacy

Life Insurance

Disability Insurance

401K Matching

FSA

Employee Assistance Program

PTO and Holidays

Job summary

Moda Health in Milwaukie, Oregon, is seeking a Senior Claims Processor for a full-time hybrid role. You will supervise staff, coach and set goals, and ensure timely and accurate processing of claims.

Applicants should have 2–4 years in medical claims processing, including leadership experience, with strong communication and analytical skills. The role requires reliability, confidentiality, and a professional business image. We offer benefits, 401K, and a supportive team environment.

Qualifications

• College degree or equivalent work experience.
• 2–4 years medical claims processing experience, including 1 year as Senior/Lead processor.
• Strong verbal, written and interpersonal communication skills.
• Strong analytical, problem solving and decision-making skills.
• Ability to work well under pressure with frequent interruptions and shifting priorities.

Responsibilities

• Supervises staff giving daily work direction, vacation scheduling, monitoring attendance, conducting performance reviews, and hiring and training new employees.
• Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
• Controls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality.
• Assists with planning by analyzing amount of work and type of work, assigns and sets priorities and decides on retraining needs.
• Motivates and coaches the processors by reviewing results with them, conveys to them what is expected of them, asks for suggestions, and fulfills the needs of training.
• Use and manipulate excel files.
• Other duties as assigned.

Skills

Medical claims processing experience

Communication skills

Analytical thinking

Problem solving

Ability to work under pressure

Punctuality

Professional image

Education

College degree or equivalent work experience

Tools

Microsoft Word

Microsoft Excel

Job description

Moda Health in Milwaukie, Oregon, is seeking a Senior Claims Processor for a full-time hybrid role. You will supervise staff, coach and set goals, and ensure timely and accurate processing of claims.

Applicants should have 2–4 years in medical claims processing, including leadership experience, with strong communication and analytical skills. The role requires reliability, confidentiality, and a professional business image. We offer benefits, 401K, and a supportive team environment.