Healthcare Claims Team Leader

2 weeks ago


Tampa, Florida, United States Ultimate Staffing Full time

Company Overview

Ultimate Staffing is a prominent player in the insurance administration sector, experiencing rapid expansion. We are seeking a dedicated Healthcare Claims Team Leader to join our dynamic team.

Position Summary

The Healthcare Claims Team Leader will oversee the daily operations of the department responsible for processing healthcare service billing. This role is crucial in ensuring that claims are accurately assessed for approval or denial based on services rendered and compliance with relevant regulations and agreements.

Key Responsibilities

  • Lead and manage the performance of the Claims Team by providing daily guidance, support, and constructive feedback.
  • Oversee claim inventory and aging processes to effectively allocate daily workloads.
  • Recruit and manage staff levels to ensure efficient and high-quality claims processing.
  • Implement resource planning strategies to enhance productivity and turnaround times.
  • Maintain up-to-date knowledge of federal and state regulations, as well as client requirements, to ensure compliance in claims and billing practices.
  • Develop and monitor performance metrics to achieve quality, timeliness, service, and productivity objectives.
  • Provide expert claims support to teams in reviewing, investigating, negotiating, processing, and adjusting claims.
  • Identify and coordinate resources for claim re-evaluations.
  • Analyze trends and generate comprehensive reports for management review.
  • Facilitate regular team meetings to discuss performance improvement, quality assurance, and documentation practices.
  • Conduct training sessions for new employees to ensure they meet performance metrics effectively.

Qualifications

  • Associate degree in a relevant field such as business administration, finance, or healthcare management, or equivalent experience.
  • A minimum of 3 years in a supervisory capacity within a healthcare claims processing environment, with knowledge of HIPPAA and HITECH standards.
  • Familiarity with benefit administration platforms is preferred.
  • Understanding of federal and state regulations governing healthcare fiscal operations.
  • Proficient in medical terminology and diagnosis coding (ICD-9 & ICD-10).
  • Strong analytical skills to interpret data related to billing and coding issues.
  • Ability to perform complex calculations related to claims processing.

Compensation

Salary range: $60,000 to $80,000 annually, with potential for performance-based bonuses and a comprehensive benefits package.

Work Schedule

This position requires an 8-hour shift, with start times between 6:30 AM and 8:00 AM, Monday through Friday.

Ultimate Staffing is an equal opportunity employer. We welcome applications from all qualified individuals without regard to race, color, national origin, age, religion, sex, sexual orientation, gender identity, marital status, disability, medical condition, genetic information, pregnancy, or military status.



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