About the Role
As a Claims Team Lead you will have the opportunity to lead a team of orthodontic claims specialists tasked with managing insurance claims for several Orthodontic practices. You will report to the Operations Managers and directly supervise a team of different skill levels, including Coordinator 1, Coordinator 2, Senior Coordinator levels and Claims Team Captain. Your primary objective will be to build a high performing team that are effective at submitting insurance claims, managing denials, and following up on claims that fail to pay as expected. In doing s,o you will play a critical role in ensuring that OrthoFi delivers best in class RCM services and allows practices to focus on delivering quality orthodontic care.
Claims & Process Management
- Supervise 7-12 direct reports handling claims submissions, denials, and follow-ups.
- Monitor key performance metrics (AR, production, quality, engagement scores) and drive team success.
- Ensure adherence to claims processing best practices to maximize timely and accurate payments.
- Identify trends, root causes, and process inefficiencies to improve workflows.
- Collaborate with Claims Account Leads (CALs) to resolve complex claims and special projects.
Leadership & Team Development
- Provide coaching, mentorship, and performance management for team members.
- Conduct bi-weekly 1:1 meetings to track progress and support individual growth.
- Facilitate training and upskilling initiatives to enhance claims processing capabilities.
- Lead effective team and departmental meetings, ensuring alignment with company goals.
- Promote a collaborative and high-performance culture, driving employee engagement and development.
Operational & Strategic Contributions
- Partner with cross-functional teams to streamline claims processes and enhance efficiency.
- Participate in the hiring process for new team members.
- Manage and approve timecards and PTO requests for direct reports.
- Ensure compliance with quality assurance (QA) standards and support initiatives to improve accuracy.
- Drive collaboration between teams and departments, proactively identifying and solving challenges.
Desired Skills and Experience
- 5+ years of experience in claims processing within the dental or orthodontic industry.
- Prior experience in a leadership or supervisory role is a plus.
- Strong analytical skills, with the ability to track and interpret data trends.
- Proficient in Google Sheets or MS Excel to analyze performance metrics.
- Excellent written and verbal communication skills with the ability to engage at all levels.
- Ability to adapt to change quickly and drive process improvements.
- Demonstrated ability to mentor and develop team members, fostering leadership growth.