Team Lead, Claim

Background
The Team Lead, Claims is responsible for overseeing the claims processing team and ensuring the efficient and accurate handling of claims. This role requires strong leadership skills, extensive knowledge of claims procedures, and a commitment to delivering exceptional customer service. The Team Lead will mentor team members, drive process improvements, and ensure compliance with company policies and regulatory requirements.

Key Responsibilities:
1. Team Leadership
a. Supervise and mentor claims staff, providing guidance and support to enhance team performance and professional development.
b. Conduct regular performance evaluations and provide constructive feedback.
2. Claims Oversight
a. Oversee the processing and assessment of claims, ensuring accuracy, compliance, and timely resolution.
b. Review complex claims to determine eligibility and validity.
3. Quality Assurance
a. Implement and maintain quality control measures to ensure adherence to company policies and regulatory standards.
b. Conduct audits of claims files and processes to identify areas for improvement.
4. Customer Interaction
a. Address escalated customer inquiries and complaints, ensuring a high level of service and satisfaction.
b. Develop and maintain strong relationships with clients and stakeholders.
5. Process Improvement
a. Identify opportunities for process improvements and lead initiatives to enhance efficiency and effectiveness within the claims team.
b. Stay updated on industry trends and best practices to inform process enhancements.
6. Reporting
a. Prepare and present reports on claims performance metrics, trends, and team achievements to management.
b. Analyze claims data to identify patterns and recommend strategic actions.
7. Collaboration
a. Work closely with other departments, such as underwriting and customer service, to resolve claims-related issues and improve overall service delivery.
b. Facilitate communication between the claims team and other departments to ensure a seamless workflow.
8. Training and Development
a. Facilitate training sessions for team members on claims procedures, best practices, and compliance requirements.
b. Support the onboarding process for new claims staff.

Qualifications
· Bachelor’s degree in medical-related courses, Insurance, or a related field in Claims.
· 5+ years of experience in claims processing, with at least 2 years in a leadership or supervisory role.
· Strong knowledge of claims management processes and insurance regulations.
· Excellent leadership and interpersonal skills.