Team Lead - Claims
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota???s leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We???re an organization that???s going places. Be part of a team that cares about you, be part of UCare.
The Team Lead in Claims is responsible for assisting Claims staff in process questions, assist in training new hires, to ensure accurate and timely processing of claims payment. Work closely with the Supervisor of Claims to identify unit training needs, identify and escalate issues as appropriate. Serve as internal department resource and contact for questions regarding complex claim requests and issues. Specific duties and responsibilities include:
- Understand and accurately interpret the Claims policies and procedures in compliance with regulatory guidelines.
- In collaboration with supervisor, develop, implement, and maintain training programs and resources for staff. Ensure timely and accurate delivery of training programs for new and existing staff.
- Identify trends that emerge related to member or department issues. Inform supervisor and assist in the development and communication of resolution.
- Acts as a liaison between Team members and Supervisor. Reports to Supervisor and escalates specific claim issues and concerns as appropriate to leadership.
- Responsible for answering questions and provide needed training of Claims staff.
- Assist Team members with complex claim issues. Review and provide subsequent training as necessary. Identify policy and procedure clarifications or changes.
- Identify system or process improvements in automated or manual processes. Assist in implementing or act as a team member on an implementation team.
- Production in the queues.
A high school diploma required with course work in medical terminology, CPT-4 and ICD-9 coding required. Relevant work experience will be considered in lieu of course work.
Five or more years of medical claims examiner experience, CPT, HCPC and ICD-9 coding and knowledge of medical terminology is required. Candidates must possess proficient computer skills and a knowledge of AMISYS and MACESS EXP. Experience working with Medicaid, General Assistance, Medical Assistance, Minnesota Care and Medicare is helpful. Amisys Claims System and Microsoft Office experience is a plus.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You???ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis???just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.