Healthcare Team Leader | Provider Services

Healthcare Team Leader | Provider Services

Work Set-up: Onsite - eligible to WFH after training based on performance and business requirements

Location: Valero, Makati City
Schedule: Graveyard | Shifting Hours

Job Summary

The Healthcare Team Leader - Provider Services is responsible for leading, coaching, and managing a team of Healthcare Customer Service Advocates who support healthcare providers and billing representatives with eligibility, claims, payments, appeals, Explanation of Benefits (EOBs), and other provider-related inquiries.

The Team Leader is accountable for driving team performance against established productivity, quality, attendance, schedule adherence, service-level, customer/provider experience, compliance, training, certification, and other account-specific Key Performance Indicators (KPIs). This role ensures Advocates follow approved workflows, accurately document interactions, meet client expectations, and receive timely coaching and performance support.

This role partners closely with Operations, Quality, Training, Workforce Management, and other support teams to ensure service delivery excellence, operational readiness, compliance adherence, and sustained performance improvement across the team.

Key Responsibilities

Team Leadership & Operations

• Lead Healthcare Customer Service Advocates supporting provider inquiries across phone, email, fax, web, and other assigned channels.
• Manage daily coverage, workflows, queues, service levels, turnaround times, and escalations.
• Monitor team performance, productivity, quality, attendance, adherence, documentation, and KPI results.
• Provide guidance and floor support for complex or escalated provider interactions.
• Partner with Operations, Workforce Management, Quality, Training, and client teams to address operational issues and performance gaps.
• Own team results and ensure timely completion of action plans and escalations.

Quality & Coaching

• Review QA results, identify error trends, and drive corrective actions.
• Conduct regular coaching, one-on-ones, performance reviews, and development discussions.
• Ensure accurate documentation and compliance with established processes and quality standards.
• Lead root-cause analysis for recurring errors, compliance risks, and provider experience concerns.
• Promote a Zero Error Mindset and escalate potential compliance or process issues.

Production Responsibilities

• Perform regular production work alongside Team Lead responsibilities.
• Maintain proficiency in applicable processes and meet established production requirements.
• Maintain 100% quality on Team Lead production work.
• Follow all client, regulatory, documentation, and operational requirements.
• Model expected productivity, accuracy, and quality standards.

KPI & Performance Management

• Ensure the team consistently meets productivity, quality, attendance, adherence, service level, turnaround, documentation, compliance, and provider experience KPIs.
• Review dashboards, scorecards, QA results, and operational reports to identify risks and improvement opportunities.
• Create and implement action plans for employees or teams below expectations.
• Clearly communicate, document, and reinforce performance expectations.

Training & New-Hire Support

• Support new-hire training, certification, nesting, production readiness, and graduation.
• Monitor new-hire performance during nesting and the first 90 days of production.
• Partner with Training and QA to address knowledge gaps through coaching, refresher training, workshops, and other development activities.
• Ensure completion of required training, assessments, certifications, and compliance requirements.
• Recommend additional coaching, training, or performance-management actions when needed.

Provider Experience & Escalations

• Ensure professional, courteous, accurate, and solution-oriented provider interactions.
• Coach Advocates on communication, active listening, probing, research, and handling complex interactions.
• Manage escalated concerns through appropriate research, resolution, documentation, and handoff.
• Identify opportunities to reduce repeat issues, unnecessary transfers, and unresolved inquiries.

Compliance & Security

• Ensure compliance with HIPAA and all applicable privacy, security, confidentiality, client, and Imagenet standards.
• Reinforce proper provider verification, access controls, documentation, and approved workflows.
• Promptly report privacy, security, compliance, or process-integrity concerns.
• Ensure completion of required compliance training and acknowledgments.

People Management

• Conduct team huddles, one-on-ones, coaching sessions, performance reviews, and development discussions.
• Accurately document coaching, attendance, quality, performance, corrective actions, and follow-ups.
• Address performance, attendance, behavioral, and compliance concerns in accordance with company policy.
• Recognize strong performance and support employee engagement, accountability, and retention.
• Escalate recurring or serious concerns to Operations leadership and Human Resources as appropriate.

Qualifications

• High school diploma or equivalent required; college degree or relevant post-secondary education is preferred.
• At least 4-5 years of experience in a healthcare contact center, provider services, claims support, or comparable healthcare operations environment.
• At least 1 to 2 years of team leadership and supervisory experience preferred.
• Working knowledge of healthcare claims, EOBs, appeals, eligibility, benefits, payment processes, provider-service workflows, and contact-center operations.
• Demonstrated ability to coach employees, interpret performance data, identify root causes, and drive measurable performance improvement.
• Ability to work in a metric-driven environment and manage team performance against productivity, quality, attendance, adherence, service-level, and compliance requirements.
• Experience with Monday.com, AWS Connect, workforce tools, QA platforms, and performance dashboards is highly preferred.
• Ability to work flexible schedules, including nights, weekends, and holidays, based on client coverage and leadership requirements.

Performance Accountability

Team Leaders are accountable for the performance, quality, compliance, engagement, and operational readiness of their assigned team regardless of work location. Remote or hybrid work is contingent upon sustained leadership effectiveness, team performance, responsiveness, and compliance with all applicable requirements. Failure to meet established KPIs or leadership expectations may result in coaching, retraining, performance management, return to onsite work, or other appropriate action in accordance with company policy.

Work Arrangement & Remote Work Eligibility

This position may require onsite presence during training, transition, new-hire nesting, team stabilization, client visits, performance-management activities, or other operational needs.

Team Leaders may be eligible for a remote or hybrid work arrangement, subject to sustained team performance, leadership effectiveness, attendance, responsiveness, security, technology, client, and business requirements.

Additional Benefits:

• Comprehensive HMO Coverage - Medical & Dental
• HMO coverage on Day 1 plus 1 dependent

About Imagenet

Imagenet is a technology-forward healthcare operations partner with more than 25 years of experience helping healthcare payers manage critical administrative and operational processes. Founded in 2000 and headquartered in Tampa, Florida, Imagenet supports 150+ health plans through its payer clients.

Our teams help improve efficiency, accuracy, visibility, and service across complex healthcare operations, including digital mailroom, claims adjudication, contact center, member communications, and related administrative functions. By combining experienced operational teams, proven processes, and purpose-built workflow technology, Imagenet helps payers keep essential processes moving for the members, providers, and communities they serve.

Imagenet operates 10 secure facilities across the U.S. and one secure facility in Manila, Philippines.

Joining Imagenet means contributing to work that supports the healthcare operations members and providers rely on every day.