Resolution Operations Lead: Claims & SLA Excellence

MedRisk; Conshohocken (Montgomery County); On-site; USD 70,000 - 100,000; Full time

Job summary

MedRisk is seeking a Team Lead, Resolution Services to guide the Resolution Team and oversee provider-specific workflows. You will ensure client SLAs, TATs, and quality standards are consistently met while driving operational excellence and revenue outcomes.

You will coach and develop Analysts, monitor performance, and collaborate with cross-functional teams to optimize workflows and communication with clients and providers.

Qualifications

• 1 year related experience in a leadership or supervisory role.

Responsibilities

• Lead and support a team of Resolution Analysts responsible for researching, analyzing, and resolving claim-related issues to ensure timely and accurate processing.
• Monitor team performance to ensure compliance with established client and provider turnaround times (TATs), SLAs, and quality standards.
• Serve as a liaison between team members, leadership, and cross-functional departments to facilitate effective communication and collaboration.
• Support the performance management process by monitoring attendance, productivity, and adherence to departmental expectations.
• Ensure analysts maintain professional, accurate, and client-focused communications with internal and external stakeholders.
• Assist in onboarding, training, coaching, and development of new and existing team members.
• Develop, maintain, and document workflows, procedures, and resolution processes to ensure consistency and operational effectiveness.
• Analyze daily, weekly, and monthly operational reports to identify trends, risks, and opportunities for process improvement.
• Drive continuous improvement initiatives that enhance workflow efficiency, service delivery, and revenue outcomes.

Skills

Leadership

Coaching

Strong communication

Analytical

HIPAA knowledge

MS Office

Tools

MS Excel

MS Office suite

Job description

MedRisk is seeking a Team Lead, Resolution Services to guide the Resolution Team and oversee provider-specific workflows. You will ensure client SLAs, TATs, and quality standards are consistently met while driving operational excellence and revenue outcomes.

You will coach and develop Analysts, monitor performance, and collaborate with cross-functional teams to optimize workflows and communication with clients and providers.