AmeriHealth Caritas • Nationwide - US
Job #2693330845
HSP Team Lead
Location: Remote, United States
Primary Job Function: Operations
ID**: 34242
Your career starts now. We are looking for the next generation of healthcare leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at ~~~.
Description:
The Team Lead's primary responsibility is supporting the daily claims process. Secondarily, they are responsible for providing support to the Team Lead Educator as required.
Responsibilities:
Reports to LOB Supervisor
Functions as a technical specialist for claims operations.
Maintains a current working knowledge of LOB processing rules, contractual guidelines, plan policies, and operational procedures
Resolves and provides directions to Front End Claims Examiners and Research Analysts regarding complex claims
Assists in managing inventory
Assists in identifying critical issues with projects and offers solutions
Creates and supports an environment that fosters teamwork, cooperation, respect, and diversity
Provides technical and peer in-service training, including side-by-side training
Prepares daily inventory reports
Assists Supervisor in assigning work to staff and attends meetings as directed by supervisor or manager
Develops and maintains working relationships with multiple functional areas in the Enterprise
Participates in OLH Processing Rule Committee
Is a knowledgeable Subject Matter Expert of each LOB-supported
Supports Claims Team Management (Director, Manager, Supervisor) with reports, unique processes, projects
Assists in addressing audit reports and quality review feedback
Provides backup support for Team Lead Educator
Education & Experience:
Associate's or Bachelor's Degree
Minimum of 4 years of experience in claims processing health and dental claims.
AC Product & Claims Knowledge
Excellent Written and Verbal Communication Skills
Leadership
Strong analytical skills
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.
EOE Minorities/Females/Protected Veterans/Disabled
AmeriHealth Caritas • Thibodaux, LA 70302 • 7 Days Ago
AmeriHealth Caritas • Newtown Square, PA 19073 • Mar 6
Kaniksu Community Health • Sandpoint, ID 83864 • 14 Days Ago
Ready Set GO Therapy, Inc. • Sausalito, CA 94965 • 3 Days Ago
StuartCo • Saint Paul, MN 55102 • Today
First Citizens Bank • Raleigh, NC 27615 • May 3