Team Lead - Health Insurance Claims

Family Health Plan (FHPL)

5 - 8 years

6 - 7 Lacs

hyderabad

Posted:10 hours ago| Platform:

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Skills Required

team handling claims adjudication health claims claims processing

Work Mode

Work from Office

Job Type

Full Time

Job Description

Role & responsibilities

Team management:
Supervise and guide a team of claims processors, delegating tasks, setting performance goals, and conducting regular performance reviews.
Claim processing oversight:
Monitor and manage the day-to-day workflow, ensuring claims are processed accurately, efficiently, and in a timely manner.
Quality assurance:
Review claims submissions to ensure they are compliant with policy terms, conditions, and relevant healthcare regulations.
Problem-solving:
Investigate and resolve complex and escalated claims issues, including discrepancies, in an accurate and timely manner.
Training and development:
Provide training and support to team members to enhance their skills and knowledge of claims processing and best practices.
Process improvement:
Collaborate with leadership to identify and implement process improvements to increase efficiency, accuracy, and service delivery.
Compliance and reporting:
Ensure adherence to internal controls, operational plans, and legal/regulatory requirements. Maintain accurate records and may be responsible for creating reports on team performance.
Communication:
Serve as a point of contact for inquiries, liaising with policyholders, healthcare providers, and other internal and external stakeholders.

Preferred candidate profile

BHMS/BUMS/BAMS graduates with registration.

5-8 years relevant experience in Insurance TPA.

Willing to work from office.

Moulika @9177141222, moulika.r@fhpl.net

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