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Lead Claims Processor Jobs (NOW HIRING)

Lead and coach claims processors. * Assign daily workloads and monitor productivity. * Monitor claim processing queues and turnaround times. * Review all team follow up queues for completion.

Lead and coach claims processors. * Assign daily workloads and monitor productivity. * Monitor claim processing queues and turnaround times. * Review all team follow up queues for completion.

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Lead Claims Processor information

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$12

$22

$34

How much do lead claims processor jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for lead claims processor in the United States is $22.34, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $25.48 per hour, depending on experience, location, and employer.

What is a Lead Claims Processor?

A Lead Claims Processor is a senior professional responsible for overseeing the processing of insurance claims within an organization. They review, evaluate, and authorize claims, ensuring accuracy and compliance with company policies and regulations. In addition to handling complex or escalated claims, they often provide guidance and support to a team of claims processors, helping to train new staff and improve workflow efficiency. Lead Claims Processors play a key role in maintaining customer satisfaction and minimizing errors in the claims process.

What are the key skills and qualifications needed to thrive as a Lead Claims Processor, and why are they important?

To excel as a Lead Claims Processor, you need in-depth knowledge of insurance policies, claims adjudication processes, and a strong attention to detail, often supported by prior experience in claims handling. Familiarity with claims management software, electronic document management systems, and possibly certifications such as AIC (Associate in Claims) are typically required. Exceptional organizational, leadership, and communication skills set top performers apart, enabling them to manage teams and resolve complex cases efficiently. These competencies ensure accurate, timely processing of claims, minimize errors, and foster a productive team environment.

How does a Lead Claims Processor typically collaborate with other departments to resolve complex claims issues?

As a Lead Claims Processor, you'll frequently work alongside teams from customer service, underwriting, and legal departments to resolve complex or disputed claims. This cross-functional collaboration ensures that claims are handled efficiently and in compliance with company policies and regulations. You may also coordinate with IT or analytics teams to improve claims processing workflows, and regularly communicate updates or training to your own team. Building strong interdepartmental relationships is essential for streamlining processes and delivering a positive customer experience.

What is the difference between Lead Claims Processor vs Claims Processor?

AspectLead Claims ProcessorClaims Processor
CredentialsHigh school diploma or equivalent; often some experience in claims processingHigh school diploma or equivalent; entry-level position
Work EnvironmentTeam-based, collaborative setting within insurance or healthcare companiesIndividual work handling claims in an office or remote setting
ResponsibilitiesOversees claims processing, mentors team members, ensures accuracyReviews and processes insurance claims, verifies information

The Lead Claims Processor typically has more experience and takes on supervisory tasks, guiding a team and ensuring quality. In contrast, Claims Processors focus on executing claims tasks independently. Both roles are essential in insurance and healthcare industries, but the Lead Claims Processor holds additional leadership responsibilities.

More about Lead Claims Processor jobs

Senior Manager, Stop Loss & Health Claims

Sun Life Financial

Wellesley Hills, MA • On-site, Remote

$68K - $102K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago


Sun Life Assurance Company of Canada rating

8.6

Company rating: 8.6 out of 10

Based on 18 frontline employees who took The Breakroom Quiz

73rd of 260 rated insurance


Job description

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Job Description:

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK.

The opportunity: The Senior Manager, Stop Loss and Health Claims leads our dynamic claims unit. In this critical role, you'll oversee complex claims operations, manage a high-performing team, and collaborate with key partners to drive our continued growth and excellence in customer service.

How you will contribute:

  • Lead Claims Operations: Direct the evaluation, investigation, negotiation, and settlement of complex claims, ensuring optimal balance between policyholder interests and company objectives.
  • Manage and Develop Staff: Supervise, mentor, and grow a talented claims team, overseeing work assignments, performance management, and professional development.
  • Optimize Processes: Monitor workflow, implement efficiencies, and ensure prompt, accurate claims processing to enhance operational effectiveness.
  • Collaborate with Partners: Work closely with third-party administrators, brokers, agents, policyholders, vendors, and legal counsel to maintain Sun Life's strong reputation and drive business growth.

What you will bring with you:

  • Ability to work with a diverse range of people
  • 5+ years of medical stop loss insurance or health insurance claims experience required, previous management/leadership experience preferred
  • Proven leadership skills and deep industry expertise
  • Strong analytical and problem-solving abilities
  • Experience in stakeholder management and customer-facing roles
  • In-depth knowledge of claims practices, state and federal laws
  • Excellent communication and negotiation skills
  • Ability to analyze and communicate complex data and trends
  • Proficiency with claims management systems and Sun Life products

Salary:

$68,200-$102,300

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!

We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email thebrightside@sunlife.comto request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Category:

Claims - Health & Dental

Posting End Date:

29/06/2026

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