Remote Claims Team Lead - Process & KPIs

CROWN ADMINISTRATORS; Texas; Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Competitive salary

Remote work flexibility

Dynamic work environment

Growth opportunities

Job summary

Health Admins is seeking a Claims Team Lead to manage a team of Claims Processors, drive performance, and ensure efficient processing of medical claims. The role combines hands‑on processing with leadership duties and KPI monitoring.

You will mentor staff, resolve escalated issues, and collaborate with management to optimize workflows and service delivery for members and providers across a remote Texas-based setup.

Qualifications

• Bachelor's degree or equivalent experience in a related field.
• 2-3 years of experience in healthcare, claims processing, or related field, including 1-2 years of leadership.
• Experience with CRM systems, Salesforce preferred.
• Experience with process improvement and team management.

Responsibilities

• Lead a team of 4-7 Claims Processors and Senior Claims Processors, providing ongoing support and guidance.
• Oversee daily claims processing tasks, ensuring timely and accurate handling of member claims and invoices.
• Serve as primary contact for escalated issues, resolving disputes with members and providers.
• Assist in training new and junior staff, providing coaching and feedback.
• Monitor department performance, track KPIs, and implement process improvements.
• Coordinate with departments to enhance the claims processing workflow for members.
• Identify inefficiencies and recommend automation or system changes to optimize processing.
• Maintain accurate member records in CRM and conduct periodic audits of claims.

Skills

Leadership

Medical terminology

Claims processing

Communication

Attention to detail

Problem solving

Multitasking

Education

Bachelor's degree or equivalent

Tools

Salesforce

Google Suite

Job description

Health Admins is seeking a Claims Team Lead to manage a team of Claims Processors, drive performance, and ensure efficient processing of medical claims. The role combines hands‑on processing with leadership duties and KPI monitoring.

You will mentor staff, resolve escalated issues, and collaborate with management to optimize workflows and service delivery for members and providers across a remote Texas-based setup.