Healthcare Claims Team Lead - Remote

Healthcare Claims Team Lead (Remote)

Job Type: Full-time 

Location: Remote 

Reporting to: Claims Supervisor

About the Role

We are seeking a highly driven Healthcare Claims Team Lead to play a critical role in launching and supporting a new client engagement. This position is ideal for a hands-on leader who thrives in fast-paced environments and enjoys building processes from the ground up.

You will lead end-to-end implementation efforts while ensuring operational readiness, cross-functional alignment, and a successful go-live. In addition to standard Team Lead responsibilities, this role requires active involvement in implementation, process design, and client onboarding.

Key Responsibilities

Implementation & Client Onboarding

• Lead end-to-end client implementation, from discovery through go-live and stabilization
• Translate client requirements into operational workflows, SOPs, and staffing models
• Develop and execute detailed implementation plans, including timelines and milestones
• Identify risks early and proactively drive mitigation strategies

Cross-Functional Coordination

• Partner with Training, QA, IT, and Workforce Management teams to ensure readiness across all workstreams
• Coordinate system setup, user acceptance testing (UAT), and access provisioning with IT and client teams
• Ensure all systems, tools, and environments are fully tested and production-ready prior to go-live

Operational Readiness & Process Design

• Support development of process documentation, job aids, and knowledge base materials
• Validate workflows for claims processing, including escalation paths and exception handling
• Ensure processes are scalable, efficient, and aligned with client expectations

Expanded Leadership Scope

• Perform standard Team Lead responsibilities including team oversight, performance management, and reporting
• Take ownership of Quality Assurance and Training functions during the implementation phase
• Provide hands-on support in building, testing, and executing processes
  

Qualifications

• Min. 5 years of experience processing easy, moderate, and complex medical claims (payer-side experience preferred)
• 2+ years in a leadership role within claims or healthcare operations.
• Proven experience in implementations, transitions, or new client launches
• Strong experience with Medicare and Medi-Cal claims, including a working knowledge of CMS guidelines and regulatory requirements.
• Prior quality assurance and training experience with demonstrated ability to identify trends  
• Previous experience leading, coaching, or mentoring teams in a claims or healthcare operations environment.
• Strong analytical skills with the ability to interpret performance data and KPIs.
• Excellent communication, organizational, and decision-making skills.
• High attention to detail and commitment to accuracy, compliance, and operational excellence.

What We Offer

• Remote work offered
• Equipment provided
• Paid training to set you up for success
• Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
• Paid Time Off (PTO)
• 7 paid holidays
• A supportive team and a company that values internal growth

Ready to Take the Lead on Something New?
Don’t miss this opportunity to shape a new client launch—click “Apply Now” and get started.

COMPANY OVERVIEW

Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.