HSP Team Lead

Your career starts now. We are looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we would like to connect with you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Description

The Team Lead's primary responsibility is supporting the daily claims process. Secondarily, they are responsible for providing support to the Team Lead Educator as required.

Responsibilities

Reports to LOB SupervisorFunctions as a technical specialist for claims operations. Maintains a current working knowledge of LOB processing rules, contractual guidelines, plan policies, and operational proceduresResolves and provides directions to Front End Claims Examiners and Research Analysts regarding complex claimsAssists in managing inventoryAssists in identifying critical issues with projects and offers solutionsCreates and supports an environment that fosters teamwork, cooperation, respect, and diversityProvides technical and peer in-service training, including side-by-side trainingPrepares daily inventory reportsAssists Supervisor in assigning work to staff and attends meetings as directed by supervisor or managerDevelops and maintains working relationships with multiple functional areas in the EnterpriseParticipates in OLH Processing Rule CommitteeIs a knowledgeable Subject Matter Expert of each LOB-supportedSupports Claims Team Management (Director, Manager, Supervisor) with reports, unique processes, projectsAssists in addressing audit reports and quality review feedbackProvides backup support for Team Lead Educator

Education & Experience

Associate's or Bachelor's DegreeMinimum of 4 years of experience in claims processing health and dental claims. AC Product & Claims KnowledgeCoordinationExcellent Written and Verbal Communication SkillsLeadershipStrong analytical skills

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.