Team Leader - Insurance

Position Purpose:

The Team Lead is responsible for leading and supporting claims representatives in the accurate and efficient review of medical bills related to auto insurance claims. This role ensures adherence to standards, regulatory requirements, and best practices in medical bill processing. Process Coach provides ongoing training, performance feedback, and process improvement guidance to enhance team effectiveness and customer satisfaction.

 

Essential Functions and Responsibilities:

1. Coach and mentor claims representatives on medical bill review procedures, documentation standards, and compliance requirements
2. Monitor team performance and provide actionable feedback to improve accuracy, timeliness, and service quality
3. Conduct audits and quality checks on processed claims to ensure consistency and adherence to policy
4. Collaborate with leadership to identify process gaps and implement improvements
5. Serve as a subject matter expert on medical bill review protocols and state-specific requirements (e.g., PIP, MedPay)
6. Support escalated claim resolution and provider communication when needed
7. Track performance metrics and contribute to reporting and analysis for operational insights.