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Claims Examiner TL - Remote
ImageNet
- Tucson, Arizona, United States
- Tucson, Arizona, United States
À propos
Location: Remote
Pay: $22$25 per hour
Target Start Date: May 1, 2026
About the Role We are seeking a highly driven Team Lead U.S. Claims (Implementation Focus) to play a critical role in launching and supporting a new client engagement. This position is ideal for a hands‑on leader who thrives in fast‑paced environments and enjoys building processes from the ground up.
You will lead end‑to‑end implementation efforts while ensuring operational readiness, cross‑functional alignment, and a successful go‑live. In addition to standard Team Lead responsibilities, this role requires active involvement in implementation, process design, and client onboarding.
Key Responsibilities
Implementation & Client Onboarding
Lead end‑to‑end client implementation, from discovery through go‑live and stabilization
Translate client requirements into operational workflows, SOPs, and staffing models
Develop and execute detailed implementation plans, including timelines and milestones
Identify risks early and proactively drive mitigation strategies
Cross‑Functional Coordination
Partner with Training, QA, IT, and Workforce Management teams to ensure readiness across all workstreams
Coordinate system setup, user acceptance testing (UAT), and access provisioning with IT and client teams
Ensure all systems, tools, and environments are fully tested and production‑ready prior to go‑live
Operational Readiness & Process Design
Support development of process documentation, job aids, and knowledge base materials
Validate workflows for claims processing, including escalation paths and exception handling
Ensure processes are scalable, efficient, and aligned with client expectations
Expanded Leadership Scope
Perform standard Team Lead responsibilities including team oversight, performance management, and reporting
Take ownership of Quality Assurance and Training functions during the implementation phase
Provide hands‑on support in building, testing, and executing processes
Qualifications
Min. 5 years of experience processing easy, moderate, and complex medical claims (payer‑side experience preferred)
2+ years in a leadership role within claims or healthcare operations.
Proven experience in implementations, transitions, or new client launches
Strong experience with Medicare and Medi‑Cal claims, including a working knowledge of CMS guidelines and regulatory requirements.
Prior quality assurance and training experience with demonstrated ability to identify trends
Previous experience leading, coaching, or mentoring teams in a claims or healthcare operations environment.
Strong analytical skills with the ability to interpret performance data and KPIs.
Excellent communication, organizational, and decision‑making skills.
High attention to detail and commitment to accuracy, compliance, and operational excellence.
What We Offer
Remote work offered
Equipment provided
Paid training to set you up for success
Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
Paid Time Off (PTO)
7 paid holidays
A supportive team and a company that values internal growth
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Compétences linguistiques
- English
Avis aux utilisateurs
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