Asst. Manager Claim Adjudication(Facets)

Advenxa; Ernakulam; On-site; INR 800,000 - 1,000,000; Full time

Job summary

Advenxa in Kochi, Kerala, is seeking an Assistant Manager Claims Adjudication (FACETS) to lead a US healthcare claims team. The role requires 5+ years in adjudication and 1+ year leadership, with 1.5 years FACETS experience mandatory. Location Infopark, shift 6:00 PM to 3:00 AM; salary 8-10 LPA. You will review claims, verify eligibility, and guide the team through complex adjudication processes in line with payer guidelines.

Qualifications

• Minimum 5 years of experience in US healthcare claims adjudication, with team-handling/leadership experience.
• Minimum 1-1.5 years of FACETS experience is mandatory.
• Location: Infopark, Kochi, Kerala; salary 8-10 LPA; shift 6:00 PM - 3:00 AM.

Responsibilities

• Lead and manage a team handling US healthcare claims adjudication processes.
• Provide effective people management, coaching, mentoring, and performance management to the team.
• Review and adjudicate US healthcare claims accurately in accordance with payer guidelines and client requirements.
• Verify member eligibility, benefits, coverage, provider information, and claim details.
• Handle claim adjustments, corrections, reprocessing, and other complex claim-related issues.

Skills

Team leadership

People management

Claims adjudication

FACETS

US healthcare knowledge

Education

Bachelor's degree

Tools

FACETS

Job description

Manage attrition and shrinkage, including tracking trends, identifying root causes, and implementing corrective actions.

Asst. Manager Claims Adjudication(FACETS)

Location: Infopark, Kochi, Kerala

Qualification: Any Degree

Experience: Minimum 5+ Years in claims Adjudication &minimum 1yr of team leading experience

Minimum 1-1.5 yrs of FACETS experience is Manadtory

Salary: 8-10LPA

Shift: 6:00 PM 3:00 AM

Requirements

• Bachelors degree or equivalent qualification in any discipline.
• Minimum 5 years of experience in US healthcare claims adjudication, preferably with team-handling/leadership experience.
• Proven experience in team leadership and people management within a healthcare claims/BPO environment.
• Strong understanding of the US healthcare insurance and claims lifecycle.
• Good knowledge of eligibility, benefits, claims processing, payment, denials, adjustments, and reprocessing.
• Demonstrated experience in attrition and shrinkage management.

Responsibilities

• Lead and manage a team handling US healthcare claims adjudication processes.
• Provide effective people management, coaching, mentoring, and performance management to the team.
• Review and adjudicate US healthcare claims accurately in accordance with payer guidelines and client requirements.
• Verify member eligibility, benefits, coverage, provider information, and claim details.
• Handle claim adjustments, corrections, reprocessing, and other complex claim-related issues.