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, providing coaching and performance evaluations
• Oversee daily medical claims processing, ensuring compliance with Medicare and CMS guidelines
• Analyze performance metrics and implement process improvements to enhance accuracy and efficiency

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 and CMS regulations
• Experience in quality assurance and training with the ability to identify trends
• Strong analytical skills to interpret performance data and KPIs