As a Lead Claims Specialist supporting the US Family Health Plan (USFHP) at Pacific Medical Centers, you''ll be the go-to authority for adjudicating purchased services claims for our enrolled capitated population - resolving complex claim situations, managing advanced processing needs, responding to customer service requests with accuracy and efficiency, and applying your expertise in TRICARE reimbursement to ensure compliant, timely claims resolution for our military beneficiary population. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.