Claims Examiner Team Leader

Job Summary

A company is looking for a Claims Examiner Team Leader to manage a team of claims examiners in processing medical claims.

Key Responsibilities

• Lead and supervise a team of 15-20+ claims examiners while maintaining personal production
• Oversee medical claims processing and ensure compliance with Medicare and CMS guidelines
• Analyze performance metrics and implement process improvements to enhance efficiency and accuracy

Required Qualifications

• Minimum 5 years of experience in processing medical claims
• At least 2 years in a leadership role within claims or healthcare operations
• Strong knowledge of Medicare and Medi-Cal claims, including CMS regulations
• Prior experience in quality assurance and training with a focus on trend identification
• Strong analytical skills for interpreting performance data and KPIs