Posted:4 hours ago| Platform: Foundit logo

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claims operations

Work Mode

On-site

Job Type

Full Time

Job Description

Team Lead Operations

Key Responsibilities:

  • Lead, supervise, and manage a team of claims adjudicators to meet accuracy, productivity, and turnaround targets.
  • Monitor and ensure compliance with SLA, HIPAA, and other regulatory standards.
  • Review complex claims, handle escalations, and provide expert resolution support.
  • Conduct regular audits, identify process gaps, and implement corrective actions.
  • Drive performance management through coaching, feedback, and periodic evaluations.
  • Support training and upskilling of team members to maintain high process knowledge.
  • Collaborate with quality, operations, and client stakeholders to improve service delivery.
  • Prepare and present reports on team performance, quality metrics, and process improvement initiatives.
  • Ensure adherence to company policies, compliance standards, and client expectations.

Mandatory Skills:

  • Minimum 4.6 years of experience in US Healthcare Claims Adjudication.
  • At least 1 year of experience as an SME (on papers).
  • Strong knowledge of claims adjudication processes, policies, and compliance requirements.
  • Excellent verbal and written communication skills.
  • Proven team-handling and leadership skills with the ability to manage performance.
  • Analytical and problem-solving ability with attention to detail.

If interested candidates send resume to [HIDDEN TEXT]

WhatsApp: 9042296456

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