Claims Team Lead

The Claims Team Lead reports to the Claims Department Manager in the MWG-Administrators Division.


The position is a nonexempt, hourly role and is located at 500 Steed Road, Ridgeland, MS 39157.

GENERAL JOB DUTIES AND RESPONSIBILITIES:

The Claims Team Lead is a crucial member of the claims department, serving as both a subject matter expert (SME) and a resource for claims team members. Claims Team Lead takes on a wide variety of tasks, all of which involve supporting the claims department operation and company products. The requirements listed here are representative of the knowledge, skills, and ability required.

• Lead and coach claims processors.
• Assign daily workloads and monitor productivity.
• Monitor claim processing queues and turnaround times.
• Review all team follow up queues for completion.
• Review complex or high-value claims for accuracy and compliance.
• Perform regular audits of processed claims to ensure quality standards.
• Identify and recommend solutions for better workflow processes within the department.
• Provide ongoing training, mentoring, and performance feedback.
• Special projects assigned by the department manager or supervisor.
• Assists with updates to training material and other department resources.
• Perform other duties and responsibilities as assigned.

EXPERIENCE AND EDUCATION REQUIREMENTS:

• High School Diploma or GED required; associate or bachelor's degree is preferred.
• Must have 1-2 years of previous medical insurance claims processing experience.
• Must be proficient in computer skills and have strong knowledge of Microsoft Outlook, Windows, Excel, and Word.
• Must be able to learn and be proficient with the software used in the TPA Department.
• Must possess time management, organizational, and problem solving.
• Must be able to work well under pressure with multiple priorities and meet deadlines.
• Must be able to multitask while maintaining attention to details.
• Ability to maintain confidentiality and privacy in every aspect of the job.

WORKING ENVIRONMENT:

• Must be able to perform in a very high paced environment and professionally handle interruptions.
• Must have the ability to work under minimal supervision.
• Must be able to prioritize projects, work multiple projects simultaneously, and meet project deadlines.
• Must possess excellent problem-solving skills and have keen attention to details.
• Must demonstrate strong written and verbal communication, interpersonal, and relationship building skills.
• Must be able to handle stressful situations appropriately.
• Must maintain confidentiality and privacy in every aspect of the job.

JOB ESSENTIAL REQUIREMENTS:

The following are job functions that an employee must be capable of performing with or without reasonable accommodation.

• Must be able to read, write, and speak English; Spanish is a plus.
• Must have basic typing skills
• Must be able to work as scheduled.
• Must possess sight and hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of the position as stated above can be fully met.
• Must be able to bend, stretch, reach, and sit or stand at a desk during 85% of the workday.
• Must be able to lift, stoop, and carry small equipment items and supplies, possibly weighing up to 20lbs.