Asst. Manager - Claims Adjudication(FACET)

Advenxa; Ernakulam; On-site; INR 450,000 - 850,000; Full time

Job summary

Advenxa in Kochi (Infopark) seeks an Assistant Manager Claims Adjudication to lead a team handling US healthcare claims adjudication with emphasis on accuracy and process adherence.

The role requires 5+ years of relevant experience, strong leadership, and deep knowledge of eligibility, benefits, and denials management. Join a growing BPO environment focused on quality and SLA compliance.

Qualifications

• Minimum 5 years of experience in US healthcare claims adjudication, with team-handling/leadership experience.
• Strong leadership and people management in healthcare claims/BPO.
• Deep knowledge of eligibility, benefits, claims processing, denials and adjustments.
• Experience with shrinkage and attrition management is mandatory.

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.
• Analyze claims to determine appropriate payment, denial, adjustment, or reprocessing.

Skills

Team leadership

People management

US healthcare claims adjudication

Attrition management

Shrinkage management

Payer guidelines

Education

Bachelors degree

Job description

Assistant Manager Claims Adjudication

Location: Infopark, Kochi

Qualification: Any Degree

Experience: Minimum 5+ Years in Claim Adjudication and relevant experience Shrinkage and Attrition is Mandatory

Salary: 4.5LPA - 8.5LPA

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 is Mandatory

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.
• Analyze claims to determine appropriate payment, denial, adjustment, or reprocessing.