Top 55 Claims lead Jobs in Washington, Dc

Claims Bluecard Analyst IV, Lead
Healthcare Management Administrators —Washington, DC
- $60,000 - $74,000 a year
- Full-time
- Remote
- Background check
- High school diploma or GED
- Analysis skills
- Free parking
- Health savings account
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Lead Tax Fraud Specialist
Office of The Chief Financial Officer —Washington, DC
- $106,763 - $137,561 a year
- Full-time
- Management
- Mid-level
- Office
- Commuter assistance
- Paid holidays
Lead Mitigation Technician
Paul Davis —Fairfax, VA
- $22 - $25 an hour
- Full-time
- 5 years
- Travel
- Ability to lift 75 pounds
- Profit sharing
- Paid training
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EHR Data Lead
Chamber Cardio —Washington, DC
- Full-time
- Remote
- 5 years
- HIPAA
- SQL
Accountant/Auditor Lead/Senior (Compliance & Audit Team), Grade 25
Montgomery County Government —Rockville, MD
- $85,937 - $137,907 a year
- Email
- CPA
- Office
- Bachelor's degree
- Wellness program
- Paid parental leave
5d
Program Manager/Training Lead
Contact Government Services, LLC —Washington, DC
- $180,000 - $200,000 a year
- Full-time
- 5 years
- Mid-level
- Supervising experience
- Health insurance
- Dental insurance
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Lead Healthcare Consultant, Payment Model Implementation - Remote
Optum —Washington, DC
- $112,700 - $193,200 a year
- Full-time
- Hybrid work
- Pass drug screening
- Office
- SQL
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Healthcare Customer Service Team Lead (Remote)
Patient Accounting Service Center, LLC —Washington, DC
- $20 - $21 an hour
- Full-time
- Remote
- Bilingual
- HIPAA
- Mid-level
- AD&D insurance
- Disability insurance
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Pharmacy Compliance Lead Consultant
Blue Cross Blue Shield Association —Washington, DC
- $113,572.92 - $153,590.12 a year
- Full-time
- Hybrid work
- 7 years
- CPA
- Customer service
- Paid holidays
- Health insurance
Medical Claims (Billing) Team Leader
GT Independence —Silver Spring, MD
- $60,000 a year
- Mid-level
- High school diploma or GED
- Mentoring
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23h
Development Lead
eKuber —Tysons Corner, VA
- Email
- Senior level
- HTML
- 10 years
Lead Customer Service Tax Specialist
Office of The Chief Financial Officer —Washington, DC
- $74,893 - $96,554 a year
- Full-time
- Research
- Mid-level
- Office
- Commuter assistance
- Paid holidays
6d
Pharmacy Revenue Analytics Program Lead
Children's National Hospital —Silver Spring, MD
- $82,222.40 - $137,051.20 a year
- Full-time
- Microsoft Word
- Microsoft Excel
- Microsoft Access
- Commuter assistance
- AD&D insurance
Lead, Health & Safety Program Manager
American Water —Alexandria, VA
- $83,550 - $137,380 a year
- Full-time
- Construction site
- Master's degree
- 8 years
- Employee stock purchase plan
- Health insurance
Lead Returns Processing Assistant, Print Team
Office of The Chief Financial Officer —Washington, DC
- $56,503 - $72,721 a year
- Full-time
- Mid-level
- Office
- Residential
- Commuter assistance
- Paid holidays
Patient Financial Services Lead
MedVanta Interco, LLC. —Bethesda, MD
- $21 - $25 an hour
- Full-time
- Microsoft Excel
- English
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Lead, 340B Growth & Partnerships
Pharmacy First Health —Washington, DC
- Full-time
- Hybrid work
- Contracts
- Senior level
- 4 years
Quick Apply
Sr. Card Services Representative/Team Lead
United States Senate Federal Credit Union —Alexandria, VA
- $69,518.23 - $104,277.35 a year
- Full-time
- Management
- Office
- Finance
- Free parking
- Health insurance
Quick Apply
14h
Lead Tax Examining Technician
Office of The Chief Financial Officer —Washington, DC
- $68,189 - $87,877 a year
- Full-time
- Mid-level
- Office
- Residential
- Commuter assistance
- Paid holidays
6d
Sr. Manager, AI Lead - Semantic Layer - Remote
CSAA Insurance Services, Inc. —Washington, DC
- $168,300 - $224,300 a year
- Full-time
- Remote
- Computer science
- Computer Science
- Product management
- 401(k) matching
1d

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claims lead jobs near washington, dc

Claims Bluecard Analyst IV, Lead

Healthcare Management Administrators -
Washington, DC

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Job Details

Full-time
$60,000 - $74,000 a year

Benefits

Free parking
Health savings account
AD&D insurance
Paid holidays
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Paid time off
Work from home
Parental leave
Vision insurance
401(k) matching
Employee discount
Opportunities for advancement
Prescription drug insurance

Qualifications

Pricing
Coaching
Blue Cross Blue Shield health insurance
High school diploma or GED
Leading team collaboration initiatives
Insurance (Financial sectors)
Excel formulas
Data manipulation

Full Job Description

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service.

We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.

What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven.

What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/

How YOU will make a Difference:

As a Claims Bluecard Analyst Lead , this role ensures accurate, compliant adjudication across complex BlueCard claims, translates BlueWeb and Association changes into operational action, partners closely with Regence and InterPlan stakeholders, and monitors and improves IPP (InterPlan Program) performance. The Claims Bluecard Analyst Lead serves as an enterprise escalation point, leads cross-functional initiatives, and drives training, quality, and process improvements that safeguard claim outcomes and member experience.

What YOU will do:

BlueWeb Review

Monitor BlueWeb for Association updates and analyze release notes to determine claim, pricing, and training impacts.
Track provider terminations and communicate impacts; coordinate continuity-of-care and disruption analysis.
Serve as SME on BlueCard/ITS claims processing rules and operational program requirements. Coach team members accordingly on guidelines and changes.

Collaboration with Regence

Coordinate Association projects and rule interpretation with Regence and InterPlan Executives.
Act as key escalation point for Plan-to-Plan issues.
Cascade InterPlan communications to internal teams.

Operational Change Leadership

Oversee complex ITS/BlueCard workflows; lead system and pricing enhancement projects.
Test and validate system updates; refine ITS/BlueCard policies and procedures.
Conduct root-cause analysis on recurring issues and implement improvements.

IPP Score Monitoring

Monitor and communicate InterPlan performance metrics (IPP).
Track quality and productivity metrics; lead improvement initiatives.

Claims Adjudication

Oversee daily ITS claims workflows and ensure timely, accurate adjudication across all claim types.
Serve as the primary escalation point for the most complex, sensitive, or high‑impact ITS/BlueCard claim issues.
Partner with leadership to refine ITS policies, update procedures, and support operational strategy
Act as a liaison with BCBS host/home plans and external partners for escalated claim issues.

Requirements

Knowledge, Experience and Attributes:

High school diploma required, Associate’s Degree preferred
5-7+ years of claims processing experience within the insurance industry
3-5 years of BCBS claims processing experience
1+ years of proven leadership experience
Expert Excel skills with the ability to manipulate data independently
Expert‑level understanding of ITS/BlueCard processing, pricing methodologies, and BCBS national programs.
Strong leadership, communication, and coaching abilities.
Ability to manage competing priorities and support team performance.
High‑level analytical skills with the ability to interpret data and drive improvements.

Benefits

Compensation:

The base salary range for this position in the greater Seattle area is $47.89/hr - $55.76/hr for a level IV and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level I, we may consider level II for highly qualified candidates.

Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law.

In addition, HMA provides a generous total rewards package for full-time employees that includes:

Seventeen (IC) days paid time off (individual contributors)
Eleven paid holidays
Two paid personal and one paid volunteer day
Company-subsidized medical, dental, vision, and prescription insurance
Company-paid disability, life, and AD&D insurances
Voluntary insurances
HSA and FSA pre-tax programs
401(k)-retirement plan with company match
Annual $500 wellness incentive and a $600 wellness reimbursement
Remote work and continuing education reimbursements
Discount program
Parental leave
Up to $1,000 annual charitable giving match

How we Support your Work, Life, and Wellness Goals

At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party.

We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.)

HMA requires a background screen prior to employment.

Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures.

HMA is an Equal Opportunity Employer.

For more information about HMA, visit: https://www.accesshma.com/

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Refine Your Search

claims lead jobs in washington, dc

Claims Bluecard Analyst IV, Lead

Lead Tax Fraud Specialist

Lead Mitigation Technician

EHR Data Lead

Accountant/Auditor Lead/Senior (Compliance & Audit Team), Grade 25

Program Manager/Training Lead

Lead Healthcare Consultant, Payment Model Implementation - Remote

Healthcare Customer Service Team Lead (Remote)

Pharmacy Compliance Lead Consultant

Medical Claims (Billing) Team Leader

Development Lead

Lead Customer Service Tax Specialist

Pharmacy Revenue Analytics Program Lead

Lead, Health & Safety Program Manager

Lead Returns Processing Assistant, Print Team

Patient Financial Services Lead

Lead, 340B Growth & Partnerships

Sr. Card Services Representative/Team Lead

Lead Tax Examining Technician

Sr. Manager, AI Lead - Semantic Layer - Remote

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