Claims Team Leader
$50.83k - $81.33kFull-time
PacificSource
Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Supervise and provide leadership and guidance to Claims Analysts and support staff regarding company policies, procedures and workflow Manage claims production and quality that meets or exceeds company standards. Resolve claims adjudication issues. Responsible for hiring, training, coaching, counseling, and evaluating team member performance. Demonstrate effective leadership by coaching to improve individual performance, develop teamwork and team support, manage change and encourage innovation, build collaborative relationships, encourage involvement and initiative, and develop increased vision and commitment to goals in others. Essential Responsibilities:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization Compensation Disclaimer The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range. Base Range:
$50,830.78 - $81,329.23 Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
- Provide supervision, coaching, training, evaluation and leadership to assigned staff. Assure claims processing, production and quality meet department and company standards.
- Evaluate performance of team members. Analyze results of performance reports for each team member to determine training needs related to personal performance and department goals.
- Oversee and assist team in providing exceptional claims processing service to members, providers, employers, agents and other insurance companies. Includes accurate interpretation of benefit and policy provisions.
- Oversee and assist with review and research of medical and dental claims and determine coverage based on contract, provider status and claims processing guidelines. Investigate and settle claims issues as needed. Relay information for dispute resolution, including research and response for grievances and appeals, to appropriate departments and personnel.
- Communicate changes in business processes and procedures to ensure team members receive information in a timely manner.
- Work collaboratively with department Training Coordinator in all aspects of initial and continued education for assigned staff.
- Oversee and assist with answering inquiries received by mail or e-mail, providing exceptional service. Write original business letters and prepare reports as needed.
- Serve on various interoffice committees as required or needed. Document and report any pertinent communications back to the team and/or department.
- Actively participate in Claims leadership peer group to ensure cross-team communication, collaboration and process efficiency result in consistent, quality claims processing outcomes.
- Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
- Coordinate business activities by maintaining collaborative partnerships with key departments.
- Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
- Actively participate as a key team member in department meetings.
- Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
- Actively participate in department or inter-departmental workgroups. Share information or issues with department leaders.
- Regularly attend team meetings and daily team Visual Board huddle.
- Meet department and company performance and attendance expectations.
- Perform other duties as assigned.
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization Compensation Disclaimer The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range. Base Range:
$50,830.78 - $81,329.23 Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to foster individual, team and company growth.
- We actively participate in efforts to improve our many communities-internally and externally.
- We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
- We encourage creativity, innovation, and the pursuit of excellence.
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Claims Team Leader in Raleigh, NC vacancy
- ...including financial performance, leasing, resident satisfaction, and team leadership. This role ensures the community meets occupancy and... ...with the Maintenance Manager. Report property liability claims, worker’s compensation claims, and property loss claims. CANDIDATE...ClaimsTemporary work
$15.5 per hour
...Supervisor by always providing leadership and knowledge to the team. Possesses the aptitude and ability to gain adequate knowledge... ...duties. Responsibilities With Regard to Workers' Compensation Claims: You are responsible for reporting all employment related...ClaimsHourly payPart timeLocal areaImmediate startAcosta Group
Raleigh, NC1 day ago- ...A leading claims adjusting firm located in Garner, North Carolina, is seeking Licensed Insurance Claims Adjusters. This opportunity allows... ...necessary skills to excel in this rewarding industry. Join a team that's dedicated to making a positive impact on lives! #J-18808-...ClaimsFlexible hours
MileHigh Adjusters Houston
Garner, NC3 days ago $80.4k - $293.8k
...Dark Web Analyst to an already outstanding team. Accenture Security helps... ...Evaluating source credibility and validating claims within underground environments Maintaining... ...change today, and we are one of the world’s leaders in helping drive that change, with strong...ClaimsFull timeWork experience placementLive inWork at officeLocal area- ...Practical Adult Insights is seeking an Insurance Fraud Investigator in North Carolina to evaluate insurance claims and verify their authenticity. This position entails collecting information about claimants, conducting surveillance, and documenting findings clearly. The...Claims
Practical Adult Insights
Raleigh, NC4 days ago - ...to get the job done right. Every day our team delivers comprehensive commercial insurance... ...(i.e., territory managers, underwriting, claims, and accounting) with information to... ...can do meaningful work, feel supported by leaders who care, and grow their careers with confidence...ClaimsFor contractors
Builders Mutual Insurance
Raleigh, NC2 days ago - ...you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather... ...be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team....Claims
MileHigh Adjusters Houston
Raleigh, NC2 days ago - Domain|Healthcare Payer|Claims Lifecycle Overview The Infosys Healthcare unit is dedicated... ...touchpoints. Join us to be a part of a team that is at the forefront of healthcare innovation... ...level About Us Infosys is a global leader in next-generation digital services and...ClaimsFull timeTemporary workRelocation
- A leading insurance adjusting firm is seeking Independent Insurance Claims Adjusters to join their team in Raleigh, North Carolina. This rewarding opportunity offers flexible work conditions and competitive compensation, allowing you to make a real difference in people'...ClaimsFlexible hours
- ...Case Manager to manage a high-volume caseload of personal injury claims from inception through resolution. This position is ideal for an... ...also collaborating effectively with attorneys and internal teams. High School Diploma required; Associate's degree preferred. Equivalent...ClaimsWork at officeLocal area
Addison Group
Raleigh, NC2 days ago $99k - $124k
...care deeply about making an impact, show up for one another as One Team, and find ways to elevate the everyday. If you're looking for... ...~4+ years of experience analyzing MMR, MOR, MAO-004 and medical claims data. ~3+ actuarial exams passed. ~ High degree of...ClaimsWork at officeRemote workWork from homeFlexible hoursStrive Health
Raleigh, NC5 days ago- ...patient records and assign accurate medical codes for diagnoses, procedures, and treatments. Prepare, submit, and follow up on insurance claims, including unpaid or denied claims. Verify patient insurance information and eligibility. Maintain accurate billing records and...ClaimsFull timeMonday to FridayDay shift
- ...formation, pronunciation, and spelling. Assess the responsibilities assigned to insurance billing and coding specialists and electronic claims processors. Describe the health care delivery system. Explain the responsibilities of the billing and coding specialist to...ClaimsPart timeImmediate startRemote workFlexible hours
ProTrain
Raleigh, NC5 days ago $45k - $65k
...Account Associate - State Farm Agent Team Member As Account Associate - State Farm Agent Team Member for Lisa Davis - State Farm... ...customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with...ClaimsFor contractorsFlexible hoursLisa Davis
Raleigh, NC5 days ago- ...their Raleigh office. This role involves the defense of physicians, hospitals, and nursing homes in complex professional liability claims. Key Responsibilities Lead complex defense strategies for medical malpractice and professional liability cases. Analyze...ClaimsPermanent employmentFull timeWork at office
AVE Staffing
Raleigh, NC29 days ago $146.3k - $306.4k
...lifecycle. You will build and lead a cost controls function and team, establishing standardized processes, systems, and reporting... ...impacts with strong documentation. Evaluate change orders and claims: pricing, entitlement, schedule linkage, and negotiation support...ClaimsContract workTemporary workRemote workWork from homeFlexible hoursShift work$75k
...Role: We are a growing firm specializing in insurance property claims and damage assessment, helping homeowners navigate the claims... ...settlements. Due to increased demand, we are expanding our Raaleigh team and looking for motivated individuals who want to build a high-...ClaimsPALM BUILD LLC
Raleigh, NC12 days ago- ...Field Claims Professional Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated and experienced field claims professional to join our team. This job handles insurance claims in the field under general supervision through the life-cycle of a claim...ClaimsLocal area
Auto-Owners Insurance
Raleigh, NC5 days ago $18.48 - $25.89 per hour
...Summary: May be responsible for performing a variety of complex duties, including but not limited to, working outstanding insurance claims having no response from payors, having claim edits, and/or having received claim form related denials.Maintains A/R at acceptable...ClaimsHourly payFull timeRemote workUNC Health Care
Raleigh, NC4 days ago- ...Enable Possibility.Strategic Analytics is a dynamic and growing team at Arch that drives innovation and transforms how the business operates... ...automate complex business decisions across underwriting and claims. This role is focused on applying AI, machine learning, and data...ClaimsFull timeTemporary workRemote work
- Accentuate Staffing is currently recruiting for a hybrid Claims processor to join an established commercial insurance company in Raleigh. This role will be hybrid (2 days from home ). The Claims Processor will be responsible for cataloguing incoming electronic documents...Claims
Accentuate Staffing
Raleigh, NC22 days ago - ...and machine learning models that improve claims outcomes, operational efficiency, and risk... ...modeling. Partner with AI Engineering teams to productionize models and integrate... ...clear, actionable insights for business leaders and operational teams. Collaborate with...ClaimsRemote work
Sedgwick
Raleigh, NC5 days ago $70k - $100k
The Shingle Master is currently looking to add 2-3 individuals to our team of Sales Consultants to assist in handling the influx of insurance claims due to storm damage such as hail and wind that have recently been affecting the Triangle area. Our company’s revenue tripled...ClaimsSeasonal work$18 per hour
...charge-to file processes Expert knowledge of insurance programs, claims and implications to outstanding receivables Expert knowledge... ...Strong organizational skills Ability to work in a team environment Ability to meet or exceed Performance Competencies...ClaimsPart timeWork at officeLocal areaShift workSedgwick
Raleigh, NC2 days ago- ...an experienced Case Manager to join our Pre-Litigation (Pre-Lit) team. Employees at Whitley Law Firm share a mission of obtaining the... ...thinker who can effectively manage a caseload of personal injury claims from inception through resolution, with guidance from the Pre-...ClaimsFull timeTemporary workMonday to Friday
Whitley Law Firm Injury Lawyers
Raleigh, NC4 days ago - ...join a personal injury law firm in Raleigh, NC. This position is responsible for managing a high-volume caseload of personal injury claims from intake through resolution while providing exceptional support and communication to clients throughout the claims process....ClaimsWork at office
Accentuate Staffing
Raleigh, NC29 days ago - ...DESCRIPTION The Martinizing Dry Cleaning team is looking for a talented and self-motivated individual to help oversee operations... ...support a benchmark store appearance Solve Customer Issues and Claims Manage Commercial Accounts Master the POS (point of sale)...ClaimsLocal areaImmediate startFlexible hours
Martinizing
Raleigh, NC1 day ago - ...looking for a Business Assistant to join our team! Why Heartland Dental? Heartland... ...in the office File patient insurance claims and follow up on outstanding claims,... ...patients they serve. Supported doctors are the leaders of their practice and retain clinical...ClaimsDaily paidWork at officeLocal area
Heartland Dental
Raleigh, NC3 days ago - ...looking for a Business Assistant to join our team! Heartland Dental believes that to... ...in the office File patient insurance claims and follow up on outstanding claims, verification... ...they serve. Supported doctors are the leaders of their practice and retain clinical...ClaimsDaily paidWork at officeLocal area
Bartram Family Dental Care
Raleigh, NC4 days ago - ...Revenue Cycle Business Office Manager (BOM) to join our fantastic team of dedicated health care professionals. Benefits include:... ...Follow-up and seek payment on insurance, Medicare and Medicaid claims Work with residents to complete Medicaid pending application process...ClaimsWork at office
SanStone Health & Rehabilitation
Raleigh, NC3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims Team Leader. Be the first to apply!
Related searches
- helpdesk team lead Raleigh, NC
- team lead full time Raleigh, NC
- group project manager Raleigh, NC
- team leader full time Raleigh, NC
- team lead data science Raleigh, NC
- team leader mental health Raleigh, NC
- disability team leader Raleigh, NC
- mobile team lead Raleigh, NC
- executive team lead asset protection Raleigh, NC
- market leader Raleigh, NC