Team leader will supervise 18-20 claim adjudicators and provide day-to-day insight on their performance while monitoring operational activities to ensure accurate and timely delivery of materials.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Provide daily direction and communication to team members so that the business deliverables are intact, efficient, and knowledgeable in manner
- Monitor operational activities of claim examiners to ensure claims are processed accurate and timely
- Offer product support, expert advice, and coaching assistance to team members and clients
- Handle team performance reviews and encourage their team to meet organizational goals
- Contribute ongoing performance feedback and conducts annual performance reviews with team
- Identify skill gaps and ensure training is provided to further develop staff
- Responsible for staff retention within the team
- Should be aware of KRA’s, KPI’s, SLA, AHT, Occupancy, Attrition, and Shrinkage
- Effectively manage team conflict and any people related issue
- Ability to handle complaints, DOI, Appeal, etc.
- Adhere to process reporting, able to draft process documents, including SOP, update tracker, issue logs etc.
- Preform quality audits for team members
- Identify new opportunities to improve operational effectiveness and customer satisfaction in addition to making recommendations for improvements
- Ability to speak to client on process related issues and lead client calls
- Graduates with a minimum of 2-3 years of experience as a Team Leader in US healthcare process (preferring payers end)
EDUCATION and/or EXPERIENCE
- Possess 5-7 years of work experience in US Health care Insurance Domain
- Experience of team handling and reporting
- Excellent communication skills both verbal and written
- Strong interpersonal, communication, and analytical skills
- Expert Knowledge of all Microsoft Office applications (Word, Excel, and PowerPoint)
- Ability to add, subtract, multiply, and divide in all units of measure
- Using whole numbers, common fractions, and decimals
- Ability to compute rates, ratio, and percent
- Ability to draw and interpret bar graphs
SOFT SKILLS COMPETENCIES:
- Customer service skills
- Integrity and honesty
- Oral communication
- Organizational and planning skills
- Good English comprehension and analytical skills
- Excellent problem-solving skills with an eye for detail
- Open to work 24/7 with mandatory US timings and night shifts
- Ready to handle work pressure and ensure deliverables within timelines
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit. The employee frequently is required to use hands and fingers to handle, feel and reach with hands and arms. The employee is occasionally required to type, talk, and hear simultaneously. The employee must regularly lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, and ability to adjust focus.