Insurance Team Leader
4 months ago
Job Title: Insurance Team Leader
**Job Description**:
Key Responsibilities:
1. Team Leadership:
- Lead, mentor, and manage a team of insurance professionals.
- Foster a collaborative and productive team environment.
- Set performance goals and monitor team progress.
2. Approval Management:
- Take charge of obtaining approvals for insurance claims.
- Ensure timely and accurate submission of all required documentation.
- Coordinate with team members to handle approval-related issues efficiently.
3. Communication with Payers/TPAs:
- Maintain and nurture strong relationships with payers and TPAs.
- Serve as the primary point of contact for communication with payers/TPAs.
- Address and resolve any issues or discrepancies in a timely manner.
4. Submission and Resubmission of Files:
- Oversee the preparation and submission of insurance claims.
- Manage the resubmission of files when necessary to ensure successful approval.
- Ensure compliance with all relevant guidelines and regulations.
5. **Quality Assurance**:
- Implement and maintain quality control measures for the insurance approval process.
- Conduct regular audits to ensure accuracy and completeness of submitted files.
- Provide feedback and training to team members to enhance performance.
6. Reporting and Documentation:
- Prepare and present regular reports on team performance and approval status.
- Maintain accurate records of all communications and transactions with payers/TPAs.
- Ensure documentation is up-to-date and readily accessible.
Qualifications:
- Bachelor’s degree in Business Administration, Insurance, or a related field.
- Proven experience in a leadership role within the insurance industry.
- Strong knowledge of insurance approval processes and documentation requirements.
- Excellent communication and interpersonal skills.
- Proficiency in submission and resubmission of insurance files.
- Ability to work under pressure and meet tight deadlines.
- Exceptional problem-solving skills and attention to detail.
Preferred:
- Established contacts within the insurance industry, particularly with payers and TPAs.
- Certification in insurance or related fields.
**Job Types**: Full-time, Permanent
Application Question(s):
- Do you have experience in the submission and resubmission of insurance claims?
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