Team Lead – Claims Processing Position Available In Williamson, Tennessee

Job Description:

At CVS Health, we’re building a world of health around everyconsumer and surrounding ourselves with dedicated colleagues whoare passionate about transforming health care.

As the nation’sleading health solutions company, we reach millions of Americansthrough our local presence, digital channels and more than 300,000purpose-driven colleagues

• caring for people where, when and howthey choose in a way that is uniquely more connected, moreconvenient and more compassionate.

And we do it all with heart,each and every day.

Position SummaryThe Team Lead for the MedicareSupplement Claims Processing team is responsible for overseeingday-to-day operations to ensure timely, accurate, and compliantadjudication of claims. This role provides leadership, coaching,and support to claims processors while partnering with internalstakeholders to drive performance, improve efficiency, and enhancethe customer experience. The Team Lead plays a key role insupporting the supervisor and ensuring departmental goals are metby understanding inventory and SLA’s

• Provide daily direction andoversight to a team of claims processors handling MedicareSupplement claims
• Monitor team productivity, quality, andturnaround time; identify trends and escalate issues as needed toleadership
• Serve as a subject matter expert on Med Supp claimguidelines, system functionality, and regulatoryrequirements
• Respond to complex claim inquiries, escalations,and process exceptions with professionalism and accuracy
• Partnerwith the supervisor to track KPIs, conduct performance reviews, andsupport employee development plans
• Collaborate with otherdepartments including Customer Service, Provider Relations, andMedical Review to resolve cross-functional issues and improveworkflow
• Lead or contribute to continuous improvementinitiatives, system updates, and process enhancements
• Ensurecompliance with internal policies and CMS/state regulationsgoverning Medicare Supplement claims
• Step in to assist withclaims processing during peak volumes or staffing shortages. Required Qualifications
• -3+ years of experience in healthinsurance claims processing, preferably with Medicare Supplementclaims
• Proven ability to lead or mentor others in a teamenvironment
• Strong knowledge of CMS guidelines, NAIC modelregulations, and Med Supp plan structures
• Excellent analytical,problem-solving, and decision-making skills
• Strong written andverbal communication skills
• Ability to prioritize multiple tasksand work effectively under pressure
• Proficiency in tools such asExcel, SQL, Tableau. Preferred Qualifications
• -Prior leadership or team leadexperience
• Demonstrated ability to work cross-functionally anddrive performance outcomes. Education
• High school diploma or equivalent workexperienceAnticipated Weekly Hours40Time TypeFull timePay RangeThetypical pay range for this role is:$18.50
• $35.

29This pay rangerepresents the base hourly rate or base annual full-time salary forall positions in the job grade within which this position falls.

The actual base salary offer will depend on a variety of factorsincluding experience, education, geography and other relevantfactors. This position is eligible for a CVS Health bonus,commission or short-term incentive program in addition to the basepay range listed above. Our people fuel our future. Our teams reflect the customers,patients, members and communities we serve and we are committed tofostering a workplace where every colleague feels valued and thatthey belong.

Great benefits for great peopleWe take pride in ourcomprehensive and competitive mix of pay and benefits

• investingin the physical, emotional and financial wellness of our colleaguesand their families to help them be the healthiest they can be.

Inaddition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (includingmatching company contributions), and an employee stock purchaseplan. No-cost programs for all colleagues including wellnessscreenings, tobacco cessation and weight management programs,confidential counseling and financial coaching. Benefit solutions that address the different needs andpreferences of our colleagues including paid time off, flexiblework schedules, family leave, dependent care resources, colleagueassistance programs, tuition assistance, retiree medical access andmany other benefits depending on eligibility.

For more information,visitWe anticipate the application window for this opening willclose on: 05/19/2025Qualified applicants with arrest or convictionrecords will be considered for employment in accordance with allfederal, state and local laws. #J-18808-Ljbffr