Claims Lead

**The Position**:
We are looking for a detail-oriented Claims Lead to join our insurance team. As a Claims Lead you will directly report to the Manager of the Claims Department and will be an integral member of the Claims Leadership Team. You will be responsible for the analysis and management of claim files within their unit.
Supervision includes claim assignments, coverage analysis, establishment of and adherence to action plans in claim files, reserve accuracy, effective negotiation, and appropriate resolution. You will be a mentor to not only the specific unit, but also the entire claim department and should be available for consultation/discussion with staff as the primary responsibility.
The Claims Lead is also responsible for staff training and development. You will work closely with other members of Claims Leadership to insure the efficient and effective resolution of issues. The Claims Lead is charged with managing pending claims, improving file quality, and controlling expenses. You are expected to function at a high level of expertise and competency, while consistently exercising good judgment and independent discretion. You are expected to support Company goals, Department Goals, and advance Company values.
Main Duties / Responsibilities
Accomplishes department objectives by supervising staff and organizing and monitoring work processes.
Maintains staff by recruiting, selecting, orienting, and training employees and developing personal growth opportunities.
Accomplishes staff job results by coaching, counselling, and disciplining employees.
Plans, monitors, and appraises job results.
Conducts training.
Implements and enforces systems, policies, and procedures.
Maintains safe and healthy work environment by establishing and enforcing organization standards and adhering to legal regulations.
Completes operations by developing schedules, assigning and monitoring work, gathering resources, implementing productivity standards, resolving operations problems, maintaining reference manuals, and implementing new procedures.
Controls expenses by gathering and submitting budget information, scheduling expenditures, monitoring variances, and implementing corrective actions.
Provides quality service by enforcing quality and customer service standards.
Contributes to team effort by accomplishing related results as needed.

**Supervisor Skills**:
Quality management
Supervision
Tracking budget expenses
Safety management
Staffing
Delegation
Performance management
Organization
Fostering teamwork
Self-development
Giving feedback

**Supervisor Requirements**:
Medical Qualification Background will be an added advantage.
At least 2 years of experience as a Claims Supervisor or in a related role.
Knowledge of Medical Terminologies, CPT codes and ICD-9 codes.
Working knowledge of the insurance industry and relevant federal and state regulations.
Computer literate and proficient in MS Office.
Excellent critical thinking and decision-making skills.
Good administrative and organizational skills.
Strong customer service skills.
Ability to work under pressure.
High attention to details

About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.