Who We Are

Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Ready to Lead Daily Operations That Keep Healthcare Flowing?

We're seeking an experienced claims professional who can oversee daily activities while ensuring efficient processing for our clients. As our Claims Team Lead, you'll balance hands-on claims work with team leadership responsibilities, maintaining workflow processes that meet client response times.

What makes this role different

✓ Operational leadership: Manage workflow processes to meet client response times while interpreting and applying departmental policies

✓ Team development: Provide ongoing training for new and existing team members while serving as liaison between staff and management

✓ Quality oversight: Conduct special analysis and reports for contracted compliance while identifying potential errors and issue

✓ Client interaction: Handle direct client contact, internal staff coordination, and vendor support to ensure satisfaction

What You'll Actually Do

Lead workflow management: Maintain workflow processes to meet client response times while interpreting and applying policies and procedures for department.

Develop team capabilities: Provide ongoing training for new and existing team members while aligning daily operations with strategic company direction.

Ensure quality compliance: Conduct and compile special analysis and reports of claim payment history for contracted compliance requirements.

Manage client relationships: Handle direct client contact, internal staff coordination, and vendor support to ensure customer and member satisfaction.

Oversee system operations: Navigate and maintain thorough system knowledge for information research while understanding and enforcing company procedures and standards.

Complete processing tasks: Meet timely completion requirements and maintain minimum production standards while reviewing plan documents and eligibility information.

What You Bring to Our Mission

The leadership foundation:

• High school diploma or equivalent required
• 2+ years experience in healthcare claims processing, preferably in third-party administrator or insurance company setting
• 2+ years experience in QicLink preferred
• Strong personal computer usage and Internet proficiency skills

The technical expertise:

• Proficiency in relevant software and claims processing systems preferred
• CPC Certification preferred
• Excellent written and verbal communication skills
• Ability to type 30 wpm minimum with accuracy

The professional qualities:

• Ability to adapt to changing priorities, workflows, and regulations in healthcare industry
• Collaborative attitude with team-oriented approach
• Strong work ethic and self-starter abilities with priority management skills
• Flexible scheduling approach as business needs dictate

Why You'll Love It Here

We believe in total rewards that actually matter—not just competitive packages, but benefits that support how you want to live and work.

Your wellbeing comes first:

• Comprehensive medical and dental coverage through our own health solutions (yes, we use what we build!)
• Mental health support and wellness programs designed by experts who get it
• Flexible work arrangements that fit your life, not the other way around

Financial security that makes sense:

• Retirement planning support to help you build real wealth for the future
• Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
• Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage

Growth without limits:

• Professional development opportunities and clear career progression paths
• Mentorship from industry leaders who want to see you succeed
• Learning budget to invest in skills that matter to your future

A culture that energizes:

• People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation
• One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges
• We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results
• Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable

The practical stuff:

• Competitive base salary that rewards your success
• Unlimited PTO policy because rest and recharge time is non-negotiable
• Benefits effective day one—because you shouldn’t have to wait to be taken care of

Ready to create a healthier world? We're ready for you.

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $22 to $30 per hour. Note that compensation may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

#WeAreHiring #PersonifyHealth

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.

Application Deadline: Open until position is filled.