Claims Resolution - Washington
3 days ago
Job description
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards.You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
The Senior Claims Resolution & Finance Team Lead is a key leadership role responsible for overseeing end‑to‑end claims management operations, financial accuracy, and process optimization within the claims resolution function.
This role manages a team of analysts and specialists focused on timely claim adjudication, dispute resolution, financial reconciliation, and compliance with internal policies and external regulations.
The Senior Team Lead acts as an operational expert, strategic partner, and coach—driving performance, ensuring quality, and advancing continuous improvement initiatives.
Your role in our missionLeadership & Team Management:
Lead, mentor, and coach claims resolution and finance teams; oversee workload, staffing, and training to achieve performance, quality, and accuracy goals.
Claims Resolution & Operational Oversight:
Manage the full claims lifecycle, resolving complex cases, establishing standards for turnaround time, accuracy, and service excellence.
Financial Reconciliation & Reporting:
Oversee financial processes including payments, reimbursements, adjustments, and reconciliations; review reports and address discrepancies or process gaps.
Process Improvement & Strategy:
Analyze workflows and metrics to identify inefficiencies; partner with IT, compliance, and finance teams to optimize processes and implement best practices.
Cross-Functional Collaboration & Compliance:
Collaborate with internal partners across Finance, Operations, Legal, and Customer Support; ensure regulatory compliance, monitor internal controls, and serve as subject matter expert for claims and financial processes.
What We're Looking ForEducation & Experience:
Bachelor's degree (or equivalent experience) in Business, Finance, Accounting, Healthcare Administration, or a related field; 5–7+ years in claims resolution, financial operations, or related roles, including 2–3+ years of leadership experience.
Claims & Financial Expertise:
Proven knowledge of claims workflows, financial reconciliation, and analytical problem-solving; high proficiency with claims management systems and MS Office.
Leadership & Team Management:
Strong skills in coaching, stakeholder management, communication, and negotiation to lead and develop high-performing teams.
Industry & Regulatory Knowledge:
Experience in BPO, healthcare, insurance, or shared services operations; familiarity with relevant regulatory environments (e.g., CMS, insurance compliance).
Core Competencies:
Operational excellence, process optimization, quality assurance, analytical thinking, conflict resolution, and strategic decision-making.
What You Should Expect In This Role
Work from Gainwell's office in downtown DC, Monday to Friday, 8:00AM to 5:00PM, Monday to Friday. This is an in-person and in-office role with no limited home or remote work opportunities.
The pay range for this position is $35, $51,300.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance.
We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
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