Claims Appeals Team Lead - Onsite - West Sacramento, CA

Summary

Your role in our mission

Essential Job Functions

• Performs complex standard and non-standard processing and quality tasks in support of outsourced services within a specific industry and functional area. Demonstrates knowledge and skills in a variety of assigned work processes.
• Understands the business of the client and related market dynamics; applies knowledge to ensure best practice procedures and continuous process improvement. Identifiies issues and reviews, recommends and implements modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions.
• Performs analyses and reports findings. Interprets, audits and reconciles reports for accuracy or completeness. Maintains log records of pertinent data and provides periodic status reports. Prepares standard and adhoc reports for management and clients.
• Researches problems and follows up with the client regarding resolution. Interfaces with management and clients to resolve issues and assists in implementing same as approved.
• Supports development and documentation of new or revised standard operating procedures.
• Handles company confidential data according to policy and guidelines. Adheres to existing security policies and procedures.
• May provide leadership and work guidance to less experienced personnel. Trains and assists team members. Monitors daily activity of employees to ensure policy and procedures are being followed. Coordinates with managers and employees to ensure adequate scheduling. Prioritizes and delegates work.

Basic Qualifications

• High school diploma or G.E.D.
• Six or more years of experience with business process service delivery and improvement, preferably in an outsourcing environment
• Experience working with client company product and/or services
• Experience working with client company industry and/or functional area
• Experience working with business solutions software

Other Qualifications

• Strong communication skills
• Strong personal computer and business solutions software skills
• Strong organization and time management skills
• Good problem solving skills
• Team leadership skills to train and assist less experienced personnel
• Ability to multi-task
• Ability to work independently and as part of a team
• Ability to assess clients' business and identify improvement opportunities

Work Environment

• Office environment

What we're looking for

What you should expect in this role