Claims Team Lead

Claims Team Lead

Lead I – BPM

Who we are:

UST HealthProof is a dynamic company with a mission to lower the cost of care and deliver the future of healthcare. Our consumer-centric approach gives our health plan customers a modern infrastructure and reduced administrative costs, helping to drive better business results for our customers — and better outcomes for our communities.

We achieve this mission together through teamwork, communication, collaboration, and focus. Our employees are our greatest assets, and we invite you to apply to be a part of our journey toward making a difference in healthcare in the United States.

You Are:

UST is searching for a Claims Team Lead who will be able to take customer support calls effectively and efficiently, resolve the issue, handle escalated calls, perform call quality monitoring and reporting, and coach team towards meeting SLAs. A Data Lead Able to process complex transactions, resolve queries from team and clarify complex scenarios, while ensuring that quality of output and accuracy of information is maintained, in alignment with SLAs.

The Opportunity:

• Be responsible for directly managing a staff of 12 - 15 associates.
• Be responsible for knowing and meeting client-specified guidelines.
• Be responsible for monitoring and management of the downline staff’s productivity targets and financial and procedural accuracy standards as established by management.
• Collaborate on special projects as assigned by the manager; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by management.
• Establish and maintain an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality.
Assemble and assign projects that may include provider data, authorizations, enrolment, or other information.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What you need:

• Solid understanding and ability to effectively lead a Claims Team
• 5+ years healthcare claims processing experience
• Good communication skills (verbal and written)
• ICD-10 CPT and HCPCS coding is a plus.
• Knowledge base of physician billing and hospital coding (ICD-10, HCPC, CPT-4), medical terminology, and authorization requirements
• Willingness to learn new skills.
• Team collaborator
• Strong work ethic
• The ability to adapt quickly to a fast-paced environment.
• A self-starter and quick learner
• Team player with an ability to collaborate.
Ability to coach the team to reach their full potential

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. As required by applicable law, UST provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range: $42,000-$64,000

Our full-time, regular associates are eligible for 401K matching, and vacation accrual and are covered from day 1 for paid sick time, healthcare, dental, vision, life, and disability insurance benefits.

What we believe :

We’re proud to embrace the same values that have shaped UST HealthProof since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity. And today, it's those same values that are inspiring us to encourage innovation from everyone, to champion diversity and inclusion, and to place people at the center of everything we do.

Humility:

We will listen, learn, be empathetic and help selflessly in our interactions with everyone.

Humanity:

Through business, we will better the lives of those less fortunate than ourselves.

Integrity:

We honor our commitments and act with responsibility in all our relationships.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

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