The Team Lead, Claims is responsible for leading and supporting a team of Claims Processors to ensure claims are processed accurately, efficiently, and in compliance with client plan rules and regulatory requirements. This role oversees daily workflow management, monitors productivity and quality performance, and provides coaching and development to strengthen team results.

The Team

Lead serves as the primary escalation point for complex claims issues, participant concerns, and processing errors. This position plays a key role in identifying process improvement opportunities and implementing changes that enhance accuracy, turnaround time, and participant satisfaction.

Key Job Responsibilities

- Lead, supervise, and support a team of Claims Processors responsible for handling daily claims processing activities.
- Monitor productivity, quality, and turnaround time metrics to ensure service expectations and KPIs are met.
- Coach, mentor, and develop team members through ongoing performance feedback and training.
- Serve as the escalation point for complex claims issues, participant disputes, and system-related errors.
- Conduct claim audits and quality reviews to ensure compliance with internal processes and client plan requirements.
- Identify claim trends, recurring errors, and workflow gaps and recommend and implement process improvements.
- Maintain and update claims SOPs, training documentation, and knowledge resources as needed.
- Partner cross-functionally with internal teams to support claim resolution, system updates, and operational improvements.




- Assist with onboarding and training of new hires and support staffing/hiring needs as requested.
- Other duties as assigned.

Required Skills

- Minimum of 7 years of total professional experience, with at least 3 years in a supervisory or people leadership role within claims, benefits administration, insurance, or a related operations environment.
- Strong knowledge of consumer benefits products (HSA, FSA, LPFSA, HRA, DCA, commuter/transit, and COBRA).
- Proven ability to manage escalations and resolve issues with urgency and professionalism.
- Robust workflow management skills, including backlog tracking and workload distribution.
- Experience coaching employees, improving performance, and driving accountability to KPIs.
- Strong analytical skills with attention to detail and a focus on accuracy and compliance.
- Excellent written and verbal communication skills.

Preferred Skills

- Prior experience leading a high-volume claims processing team (10+ associates preferred).
- Experience conducting audits, QA monitoring, and call/claim calibrations.
- Strong experience preparing dashboards, reports, and performance summaries for leadership.
- Familiarity with U.S. healthcare benefit claims processing and substantiation requirements.
- Experience supporting process transitions, client implementations, or system migrations.
- Prior experience working in a BPO or shared services environment supporting U.S. clients.
- Exposure to Salesforce reporting, workflow tools, or claims management systems.

📌 Claims Team Lead (Hyderabad)
🏢 Clarity Benefit Solutions
📍 Hyderabad