Team Lead, Claims Position Available In Miami-Dade, Florida

Team Lead, Claims Independent Living Systems – 2.8

Miami, FL Job Details Full-time Estimated:

$51.1K – $64.9K a year 16 hours ago Qualifications Mid-level 3 years Analysis skills Bachelor’s degree Leadership Communication skills Full Job Description About the

Role:

The Team Lead, Claims will play a pivotal role in overseeing the claims processing team within our Health Care Services division. This position is responsible for ensuring that all claims are processed accurately and efficiently, leading to timely reimbursements and customer satisfaction. ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. The Team Lead will also be instrumental in developing and implementing best practices to enhance the claims workflow and reduce errors. Additionally, this role involves mentoring and training team members to foster a high-performance culture. Ultimately, the success of this position will directly impact the financial health of the organization, and the quality of service provided to our members and providers. ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations

Minimum Qualifications:

Bachelor’s degree in a related field or equivalent work experience. A minimum of 3 years of experience in claims processing within the health care industry. Proven leadership experience, with the ability to motivate and guide a team. Relevant experience may substitute for the educational requirement on a year-for-year basis.

Preferred Qualifications:

Certification in claims management or a related area. Experience with electronic claims processing systems and software. Knowledge of health care regulations and compliance standards.

Responsibilities:

Supervise daily operations of the claims processing team to ensure compliance with company policies and regulatory requirements. Review and analyze claims to identify trends, discrepancies, and areas for improvement. Provide training and support to team members, fostering a collaborative and productive work environment. Coordinate with other departments to resolve complex claims issues and enhance overall service delivery. Prepare and present reports on team performance, claims metrics, and process improvements to senior management.

Skills:

The required skills for this position include strong analytical abilities, which are essential for reviewing claims and identifying discrepancies. Leadership skills will be utilized daily to inspire and guide team members towards achieving their goals. Excellent communication skills are necessary for effectively collaborating with other departments and presenting findings to management. Familiarity with claims processing software will enhance efficiency in managing workflows and resolving issues. Preferred skills, such as knowledge of health care regulations, will be beneficial in ensuring compliance and maintaining high standards in claims processing.