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SalaryOverview: This position works closely with the team supervisor with minimal supervision and provides assistance in the day-to-day monitoring of team performance in the areas of initiating Long Term Care Insurance Claims and the handling of claims’ inquiries. The Team Lead assists in monitoring staffing, assigning work as needed to ensure that team and department quality standards, and internal and regulatory time standards are met, and modeling a sense of urgency in the meeting of these standards. This position requires the ability to make routine and complex decisions independently. The Team Lead will provide constructive feedback to staff as required and training for new and existing employees, acting as the team’s technical claims resource. The Team Lead will provide performance feedback to the supervisor upon request. This job requires the ability to motivate and be a positive role model for others.
Job Duties
1. Provides back-up for the Supervisor on tasks within the position’s scope of authority.
2. Signs on to phone queue and is available to make/take calls during regular, documented work hours. Handles inquiries from claimants and their representatives, agents, vendors and other customers, both inside and outside of the Company; understands and effectively utilizes the call escalation process.
3. Understands and consistently utilizes available resources in opening claims and handling inquiries, provides accurate descriptions of key policy provisions and claims processes.
4. Effectively secures the information necessary for thorough completion of the Claims Intake; probes when needed to clarify information and contradictory statements and requests the information required for eligibility review.
5. Precisely and consistently updates the claims system comments to reflect status; information obtained, documentation required/requested, details of inquiries, contact information and actions taken, and appropriate follow-up target dates. Sends the required forms to the claimant or responsible party and sets up the file
6. Assists the supervisor in monitoring staffing, and distributing calls and tasks as needed in order to ensure team and departmental compliance in meeting Internal and Regulatory time standards.
7. Provides training and mentoring for new specialists and representatives and for existing staff as required.
8. Handles PHI appropriately, adhering to HIPAA regulations and Company standards.
9. Attends staff meetings, employee development sessions and works on special projects as assigned.
10. Upholds performance standards
- Performs all job duties in accordance with deadlines established by management
- Performs all job duties in accordance with departmental standards for accuracy, quality and productivity.
Prerequisites for the Job
Minimum 2 years previous experience in long term care or disability claims experience or equivalent.
College degree preferred.
Proficiency in oral and written English language communication
Willingness to work cooperatively with others
Detail-oriented
Able to manage multiple tasks and projects under time constraints
Previous experience using email, Internet, Windows and Microsoft Office and other applicable computer systems
Well organized
High school diploma or GED
Physical and mental requirements for General Office personnel
All candidates must show proof of COVID-19 vaccination upon offer given, or become vaccinated after offer is given.
Job Type: Full-time
Pay: $41.78 - $52.22 per hour
Benefits:
- 401(k) 6% Match
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- Work from home
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
- Call center
- Office
- Remote
Education:
- Associate (Required)
Experience:
- Microsoft Office: 3 years (Preferred)
- long term care claim: 3 years (Required)
Work Location: Remote
