Remote Claims Team Lead – Processing & Optimization

CROWN ADMINISTRATORS; Clifton (TX); Remote; USD 65,000 - 95,000; Full time

Job summary

Health Admins is seeking a Claims Team Lead to bridge Claims Processors and Management, guiding daily processing and KPI tracking. This role combines hands-on claims work with leadership duties to support efficient workflows and quality service for members.

You will mentor staff, drive process improvements, and coordinate with other departments while ensuring compliance and high standards of accuracy. Remote work flexibility is offered.

Qualifications

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

Responsibilities

• Lead a team of 4-7 Claims Processors and Senior Processors, guiding escalated cases.
• Oversee daily claims processing, review invoices and payments per guidelines.
• Serve as primary contact for escalated issues with members/providers.
• Train and mentor junior staff.
• Monitor KPIs and collaborate to improve workflows.
• Coordinate with departments to improve the claims experience.
• Suggest automation and system changes to optimize processing.
• Ensure CRM records accuracy and conduct audits.

Skills

Leadership

Medical terminology

Communication

Attention to detail

Multitasking

Problem solving

Education

Bachelor's degree or equivalent

Leadership experience

Healthcare experience

Tools

Salesforce

CRM software

Google Workspace

Job description

Health Admins is seeking a Claims Team Lead to bridge Claims Processors and Management, guiding daily processing and KPI tracking. This role combines hands-on claims work with leadership duties to support efficient workflows and quality service for members.

You will mentor staff, drive process improvements, and coordinate with other departments while ensuring compliance and high standards of accuracy. Remote work flexibility is offered.