Claims Operations Lead

Job Summary

A company is looking for a Lead Analyst, Claims.

Key Responsibilities

• Analyze and review claims for accuracy, completeness, and eligibility
• Provide leadership and coaching to junior staff while preparing and submitting claims data for multiple clients
• Ensure adherence to claim timeliness and accuracy performance standards, while assisting with quality control projects

Required Qualifications

• Bachelor's degree in a relevant field is preferred
• 6+ years of relevant claiming experience is required; previous leadership experience is preferred
• Strong Microsoft application skills and ability to manage a large volume of claims
• Existing knowledge or experience with state government, health insurance payment systems (particularly Medicaid), is highly advantageous
• Ability to evaluate, coordinate, and perform complex planning and administrative tasks