Team Lead Operations

Job Title: Team Lead Operations – Claims Adjudication (US Healthcare)
Location: [Indore]
Experience: Minimum 4.6 years in US Healthcare Claims Adjudication, including at least 1 year as SME (on papers)

Role Overview

The Team Leader – Claims Adjudication is responsible for supervising a team of claims processors/adjudicators to ensure accurate and timely adjudication of healthcare/insurance claims in alignment with policies, compliance standards, and service-level agreements (SLAs). The role requires strong domain expertise, people management, and quality oversight, along with the ability to drive operational excellence and continuous improvement.

Key Responsibilities

• Lead and manage a team of claims adjudicators to meet daily/weekly/monthly SLA targets.
• Monitor claim processing accuracy and ensure compliance with HIPAA, CMS, and client-specific regulations.
• Conduct regular quality audits and implement corrective action plans where needed.
• Act as Subject Matter Expert (SME) to resolve escalations and provide process guidance.
• Manage team schedules, productivity tracking, and performance appraisals.
• Deliver training, coaching, and mentoring to enhance team capability and efficiency.
• Collaborate with Quality, Training, and Operations teams to address process gaps.
• Drive process improvement initiatives to reduce errors and improve turnaround times.
• Prepare and share daily/weekly/monthly reports with management and clients.
• Ensure adherence to compliance, data privacy, and organizational policies.

Required Skills & Qualifications

• Minimum 4.6 years of experience in US Healthcare Claims Adjudication.
• At least 1 year of proven experience as SME (on papers).
• Strong knowledge of healthcare claims adjudication processes and compliance frameworks.
• Good communication skills (oral & written) with ability to manage client interactions.
• Strong leadership, team management, and conflict resolution skills.
• Proficiency in MS Office tools (Excel, PowerPoint, Word) for reporting and analysis.
• Ability to work in a fast-paced environment with high attention to detail.

If your interested send your resume to Harshini@aegan-global.com

Or Whatsapp: 9042296456

Job Type: Full-time

Work Location: In person