Claims Examiner Team Leader

A company is looking for a Claims Examiner Team Leader to manage a team of claims examiners in processing medical claims.

Key Responsibilities

Lead and supervise a team of 15-20+ claims examiners, providing coaching and performance evaluations

Oversee daily medical claims processing, ensuring compliance with Medicare and CMS guidelines

Analyze performance metrics and implement process improvements to enhance accuracy and efficiency

Required Qualifications

Minimum 5 years of experience in processing medical claims

At least 2 years in a leadership role within claims or healthcare operations

Strong knowledge of Medicare and Medi-Cal claims and CMS regulations

Experience in quality assurance and training with the ability to identify trends

Strong analytical skills to interpret performance data and KPIs