Claims Team Lead

Job Summary

A company is looking for a Claims Examiner Team Lead (Implementation Focus) to lead client engagement and implementation efforts remotely.

Key Responsibilities

• Lead end-to-end client implementation and develop operational workflows
• Coordinate with cross-functional teams to ensure operational readiness and system testing
• Support process design and documentation while managing team performance and quality assurance

Qualifications

• Minimum 5 years of experience processing medical claims, with payer-side experience preferred
• At least 2 years in a leadership role within claims or healthcare operations
• Proven experience in client implementations or transitions
• Strong knowledge of Medicare and Medi-Cal claims and CMS guidelines
• Experience in quality assurance and training, with analytical skills to interpret performance data