Healthcare Claims Operations Team Lead - Washington, DC (On-site)

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: As a Healthcare Claims Operations Team Lead at Gainwell, you will lead a team responsible for medical claims processing, resolution, and financial reconciliation supporting Medicaid and Medicare programs. You will oversee end-to-end healthcare claims operations, including claims adjudication, complex issue resolution, payment accuracy, and compliance with CMS guidelines. This role serves as a subject matter expert in health insurance claims workflows and financial processes, while driving operational efficiency, quality, and continuous improvement. Your role in our mission: - Lead, mentor, and develop a team supporting medical claims processing, adjudication, and resolution - Oversee the full lifecycle of healthcare claims, ensuring accuracy, timeliness, and service excellence - Resolve complex and escalated Medicai...