Position Summary
Blue Water Benefits Administrators is seeking a motivated and detail-oriented Team Leader to serve as a frontline support resource for our claims and customer service teams. This role plays a critical hands-on function—supporting adjusters and customer service representatives with daily questions, assisting with claims processing and call coverage during peak volumes and escalating operational issues to leadership when needed.
The ideal candidate is an experienced medical claims professional who thrives in a fast-paced environment, enjoys helping teammates succeed and takes pride in delivering accurate, timely, and high-quality service.
Key Responsibilities
Frontline Team Support
- Serve as a primary point of contact for routine questions from adjusters and customer service representatives
- Provide guidance on claims processing, benefit interpretation and workflow issues
- Escalate trends, concerns and operational challenges to supervisors and managers
Claims Processing & Call Support
- Process medical claims accurately and efficiently in accordance with plan documents and internal procedures
- Answer inbound telephone calls and support customer service functions as volume and backlogs require
- Request and review additional documentation to support claims determination
Technical & Quality Assistance
- Review and interpret benefits based on plan documents and internal guidelines
- Respond to inquiries from internal teams, members and external partners
- Monitor claim and call activity to help ensure productivity, quality and service standards are met
Operational Awareness
- Assist leadership by identifying workflow issues, training needs and improvement opportunities
- Support consistency in processes, documentation usage and service delivery
Qualifications & Experience
- 2–5 years of medical claims processing experience in a health care administration or insurance environment
- Strong understanding of claims workflows, benefit interpretation and customer service operations
- Excellent attention to detail and commitment to accuracy
- Proven ability to multitask and adapt in a high-volume setting
- Strong written and verbal communication skills
- Reliable attendance and professional work ethic
Preferred Attributes
- Team-oriented professional who enjoys supporting peers
- Calm and solutions-focused under pressure
- Technically strong with a willingness to assist wherever needed
- Interested in career growth within health care operations and leadership
Why Join Blue Water Benefits Administrators
Blue Water Benefits Administrators is a privately held, growing health care administrator that values service excellence, collaboration and continuous improvement. We offer:
- Competitive compensation
- Comprehensive benefits package
- Remote-friendly work environment
- Supportive and experienced leadership
- Career development and advancement opportunities