Strategic Claims Team Leader

PacificSource; Springfield (IL); On-site; USD 51,000 - 81,000; Full time

Job summary

PacificSource in Springfield, IL seeks a Supervisory Claims Analyst to lead the claims team, coaching staff and aligning workflow with company standards. You will supervise processing, ensure accurate benefit interpretation, and resolve issues across members, providers and employers.

Strong leadership, communication and analytical skills are required, with experience in claims processing, HIPAA compliance and continual process improvement in a dynamic health plan environment.

Qualifications

• Minimum of 3 years of experience in closely related insurance field or 3 years of supervisory experience.
• Requires high school diploma or equivalent.
• Advanced knowledge of medical terminology, CPT/ICD-10 coding.
• Proficient in Microsoft Word and Excel.
• Ability to lead and coach staff.

Responsibilities

• Provide supervision, coaching, training, evaluation and leadership to assigned staff.
• Assure claims processing, production and quality meet department and company standards.
• Evaluate performance of team members.
• Analyze results of performance reports for each team member to determine training needs.
• Oversee and assist team in providing claims processing service to members, providers, employers and others.
• Oversee and assist with review and research of medical and dental claims and determine coverage.
• Investigate and settle claims issues as needed.
• Coordinate business activities with key departments and drive process improvements.

Skills

Accountable leadership

Collaboration

Communication (written/verbal)

Critical Thinking

Decision Making

Influencing

Listening (active)

Organizational skills/Planning and 7

Education

High school diploma or equivalent

Job description

PacificSource in Springfield, IL seeks a Supervisory Claims Analyst to lead the claims team, coaching staff and aligning workflow with company standards. You will supervise processing, ensure accurate benefit interpretation, and resolve issues across members, providers and employers.

Strong leadership, communication and analytical skills are required, with experience in claims processing, HIPAA compliance and continual process improvement in a dynamic health plan environment.