Assistant Manager - Claims

ExlService Holdings, Inc.; Ernakulam; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

EXL Talent Acquisition Team is seeking an Assistant Manager to oversee healthcare claims processing and adjudication. You will lead a team of claims adjudicators, mentor staff, and optimize Facet applications to drive accuracy and efficiency.

You will ensure compliance with healthcare regulations, review complex claims, provide performance feedback, and communicate with clients to maintain high satisfaction.

Qualifications

• Minimum 5 years of experience in healthcare claims adjudication and management.
• Hands-on experience with Facets applications.
• Proven track record in leading and mentoring teams.
• Bachelor's degree in a healthcare-related field preferred.

Responsibilities

• Manage and oversee a team of claims adjudicators, providing guidance and support.
• Ensure timely and accurate processing of healthcare claims, adhering to industry standards and regulations.
• Review and analyze complex claims, making informed decisions on claim adjudication.
• Implement and maintain efficient workflows and processes within the claims department.
• Stay updated with healthcare industry trends and changes in regulations, ensuring compliance.
• Collaborate with cross-functional teams to resolve complex claims and escalate issues as needed.
• Provide regular performance feedback and conduct performance appraisals for team members.
• Mentor and develop team members, fostering a culture of continuous learning and improvement.
• Maintain strong communication with clients and stakeholders, ensuring their satisfaction.

Skills

Team leadership

Claims adjudication

Process improvement

Stakeholder communication

Mentoring

Education

Bachelor's degree

Tools

Facet applications

Job description

We are looking for an Assistant Manager to join our Team. This role is crucial in overseeing the efficient processing of healthcare claims and ensuring accurate adjudication. The Assistant Manager will lead and mentor a team, utilizing their expertise in Facet applications to streamline processes and enhance overall performance.

Responsibilities

• Manage and oversee a team of claims adjudicators, providing guidance and support.
• Ensure timely and accurate processing of healthcare claims, adhering to industry standards and regulations.
• Review and analyze complex claims, making informed decisions on claim adjudication.
• Implement and maintain efficient workflows and processes within the claims department.
• Stay updated with healthcare industry trends and changes in regulations, ensuring compliance.
• Collaborate with cross-functional teams to resolve complex claims and escalate issues as needed.
• Provide regular performance feedback and conduct performance appraisals for team members.
• Mentor and develop team members, fostering a culture of continuous learning and improvement.
• Maintain strong communication with clients and stakeholders, ensuring their satisfaction.

Qualifications

• Bachelor's degree in any field, with a preference for healthcare-related disciplines.
• Minimum 5 years of experience in healthcare claims adjudication and management.
• Proven track record of successfully managing and leading a team.
• In-depth knowledge of Facet applications and their application in healthcare claims processing.
• Hands on experience in Facets application.