NASCO/FACETS

Benefits & Claims Team Lead OpTech LLC

•4.2 Detroit, MI Job Details Contract $45

•$47 an hour 1 day ago Benefits Health insurance Dental insurance 401(k) Qualifications Benefits administration Managing technical support teams Teamwork Team supervision Interpersonal skills Technical documentation Health insurance policy knowledge Configuration management Incident Escalation Quality assurance experience within IT Medical claims processing software Team development Supervising experience Bachelor's degree Mentoring Leading team collaboration initiatives Managing insurance claims teams Business Administration Technical training Capacity planning Training & development Business operations Workforce management Escalation handling Project stakeholder communication Health insurance management Cross-functional communication Stakeholder management Full Job Description

NASCO / FACETS

Benefits & Claims Team Lead Position Type:

Contract Assignment Location:

Remote / Hybrid

•Detroit, Michigan Position Overview This role is integral to advancing our benefits & claims systems through strategic leadership and technical expertise. If you are committed to excellence in project delivery within complex enterprise environments—particularly those involving cloud computing solutions—this opportunity is designed for you. We are seeking a

NASCO / FACETS

Benefits & Claims Team Lead to oversee day-to-day operations for a technical team supporting enterprise health plan systems. In this role, you will manage workload distribution, drive Service Level Agreement (SLA) performance, provide quality oversight, and serve as the primary operational escalation point for complex NASCO and FACETS benefits and claims issues. The ideal candidate brings deep healthcare payer experience across NASCO and/or FACETS environments, paired with proven leadership skills in training, mentoring, capacity planning, and process improvement.

Key Responsibilities Team Leadership & Development:

Lead, coach, and develop a team of technical analysts and specialists supporting NASCO and FACETS benefits and claims systems.

SLA & Production Management:

Monitor daily production metrics, turn-around times, and SLAs to ensure work is completed accurately and within target timeframes.

Quality Assurance & Auditing:

Perform quality reviews, audit team output, and ensure benefit configurations and claims processing workflows adhere to established standards and corporate policies.

Workforce Planning:

Coordinate capacity planning, assign daily workloads, and adjust resources to meet fluctuating volume demands across multiple project initiatives.

Escalation Management:

Serve as the primary point of contact for complex benefit rules, claims processing errors, system bugs, and operational escalations.

Training & Documentation:

Develop and deliver training programs for new and existing team members; maintain standard operating procedures (SOPs), knowledge bases, and process documentation.

Cross-Functional Collaboration:

Partner with business stakeholders, claims operations, IT engineering, configuration coders, vendors, and executive leadership to resolve system defects and streamline workflows.

Process Improvement:

Identify operational bottlenecks, implement process enhancements, and ensure consistent execution across the team.

Required Qualifications Experience:

5+ years of experience working within healthcare claims processing, benefits administration, or health plan operations.

Platform Expertise:

Hands-on experience working with NASCO (including Benefit File) and/or FACETS platforms.

Team Leadership:

Proven track record leading, mentoring, training, or supervising technical or operational teams in a healthcare payer environment.

Operations & SLA Management:

Demonstrated experience managing production metrics, quality assurance frameworks, workforce capacity, and operational escalations.

Domain Knowledge:

Deep understanding of medical insurance benefit structures, claims adjudication logic, cost-sharing mechanics (copays, deductibles, coinsurance, accumulators), and medical policy.

Communication:

Excellent verbal and written communication skills with strong organizational, documentation, and stakeholder management abilities.

Preferred Qualifications NASCO Specialty Tools:

Direct experience with NASCO 3270/Mainframe , BFAST , BFM , or Benefit File Change Service Requests (CSRs).

Configuration & Testing:

Hands-on experience with NASCO Benefit File configuration/coding, FACETS product/plan setup, or system claims testing.

Payer Experience:

Previous experience working within a Blue Cross Blue Shield (BCBS) plan or major healthcare payer organization.

Multi-Platform Breadth:

Operational experience covering both NASCO and FACETS platforms simultaneously.

Education:

Bachelor's degree in Business Administration, Information Systems, Healthcare Administration, or a related field. OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! By submitting your application, you acknowledge that recruiting technologies, including AI-assisted tools, may be used to support candidate evaluation, sourcing, matching, and communications. OpTech is an Equal Opportunity Employer (EOE), all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Pay:

$45.00

•$47.00 per hour Expected hours: 40.0 per week

Work Location:

Hybrid remote in Detroit, MI 48243