Remote Claims Team Lead — Process Optimizer

Health Admins, Inc.; United States; Remote; USD 70,000 - 110,000; Full time

Benefits offered by this job

Competitive salary and benefits

Remote work flexibility

Growth and development opportunities

Job summary

Health Admins, Inc. in the United States seeks a Claims Team Lead to bridge the gap between frontline processing and management, ensuring smooth operations and efficient claims workflows. You will guide a team of 4–7 processors and assist with escalated cases.

The role combines hands-on processing with leadership duties, tracking KPIs, mentoring team members, and driving workflow improvements to meet department and company goals with a strong focus on service quality.

Qualifications

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

Responsibilities

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

Skills

Leadership

Medical terminology

Claims processing

Communication

Attention to detail

Problem solving

Multitasking

Education

Bachelor's degree or equivalent

Tools

Salesforce

Job description

Health Admins, Inc. in the United States seeks a Claims Team Lead to bridge the gap between frontline processing and management, ensuring smooth operations and efficient claims workflows. You will guide a team of 4–7 processors and assist with escalated cases.

The role combines hands-on processing with leadership duties, tracking KPIs, mentoring team members, and driving workflow improvements to meet department and company goals with a strong focus on service quality.