Senior Medical Claims Lead & Workflow Manager

Lawelawe Training Services Inc; San Antonio (TX); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Comprehensive health and wellness plan

Retirement savings options with match

Professional growth opportunities

Job summary

Lawelawe Training Services Inc is seeking an experienced Claims Examiner Team Lead to support medical claims and healthcare cost recovery for a federal healthcare customer. You will assist the Program Manager with workload distribution, quality checks, and scheduling, while guiding junior staff and ensuring data integrity across systems.

The role requires navigating multiple government systems, protecting PHI, and maintaining timely communication with insurers, attorneys, and government

Qualifications

• Three years of experience in medical claims, insurance claims, healthcare administration, billing, collections, or a related field.
• At least one year of experience as a team lead, supervisor, or work coordinator.
• Associate or bachelor’s degree in healthcare administration, business administration, paralegal studies, finance, insurance, or related field preferred.
• Ability to balance workloads, track deadlines, and coordinate priorities across a team.
• Experience with federal healthcare programs, DoD, or government contractors is preferred.

Responsibilities

• Distribute and balance claims workloads based on case complexity and deadlines.
• Monitor progress and recommend adjustments to the Program Manager.
• Coordinate shared workstation usage and rotating on-site schedule.
• Identify scheduling conflicts and elevate issues to the Program Manager.
• Provide guidance and mentoring to Claims Examiners and assist onboarding.
• Maintain assigned claims workload and perform lead-coordination duties.
• Enter and manage claims data in government systems like ACMP and SharePoint.
• Prepare notices of claim, appeals, and routine correspondence for review.

Skills

Attention to detail

Team leadership

Claims processing

HIPAA compliance

Communication skills

Education

Healthcare administration / business administration degree

Tools

ACMP

ABACUS

DEERS

GFEBS

JLV

MHS GENESIS

PEPR

SharePoint

Job description

Lawelawe Training Services Inc is seeking an experienced Claims Examiner Team Lead to support medical claims and healthcare cost recovery for a federal healthcare customer. You will assist the Program Manager with workload distribution, quality checks, and scheduling, while guiding junior staff and ensuring data integrity across systems.

The role requires navigating multiple government systems, protecting PHI, and maintaining timely communication with insurers, attorneys, and government