Team Leader - Operations (Claims)

MDI NetworX; Maharashtra; On-site; INR 800,000 - 1,500,000; Full time

Job summary

MDI NetworX in Pune invites applications for a Team Leader role in healthcare adjudication. The candidate should have 5+ years of experience in adjudication/adjustments/provider maintenance and strong US healthcare knowledge, including CPT and Diagnosis codes.

The role requires leadership of 10–15 associates, ability to work across shifts, effective communication with stakeholders, and capability to conduct sessions and provide OJT support.

Qualifications

• Experience as Team Leader / Designated Team Leader for at least one year.
• Minimum 5+ years in Adjudication / Adjustments / Provider Maintenance.
• Willing to work in any provided shift / time.
• Strong US Healthcare Knowledge.
• Sound knowledge of CPT Codes / Diagnosis Codes.
• Awareness of Authorization Process.
• Knowledge of pre-adjudication and post-adjudication processes of the Claim Life Cycle.
• Ability to comprehend English.
• Flexible with shift timings.
• Ability to work independently.
• Ability to communicate with various stakeholders.
• Ability to conduct sessions and provide OJT Support.

Responsibilities

• Assist team members with queries and take ownership of targets and goals.
• Manage a team of 10-15 associates.
• Adhere to attendance, punctuality, reporting, and completion of work.

Skills

Team Leader / Designated Team Leader

US Healthcare Knowledge

CPT/Diagnosis codes

Authorization Process

Pre-adjudication & Post-adjudication

Communication with stakeholders

OJT / conduct sessions

English comprehension

Shift flexibility

Independent work capability

Team management (10-15 associates)

Job description

• The candidate should have worked as a Team Leader / Designated Team Leader for at a year.
• Should have minimum 5+ years in Adjudication / Adjustments / Provider Maintenance
• Should be willing to work in any provided shift / time.
• Should have strong US Healthcare Knowledge
• Should have sound knowledge of CPT Codes/Diagnosis Codes
• Should be aware of Authorization Process
• Should know the pre-adjudication and post adjudication processes of Claim Life Cycle
• Should be able to comprehend English
• Should be flexible with shift timings
• Should be able to work independently
• Should be able to communicate with various stakeholders
• Should be able to conduct sessions and provide OJT Support.

Pune

Eligibility

• The candidate should have worked as a Team Leader / Designated Team Leader for at a year.
• Should have minimum 5+ years in Adjudication / Adjustments / Provider Maintenance
• Should be willing to work in any provided shift / time.
• Should have strong US Healthcare Knowledge
• Should have sound knowledge of CPT Codes/Diagnosis Codes
• Should be aware of Authorization Process
• Should know the pre-adjudication and post adjudication processes of Claim Life Cycle
• Should be able to comprehend English
• Should be flexible with shift timings
• Should be able to work independently
• Should be able to communicate with various stakeholders
• Should be able to conduct sessions and provide OJT Support.

Responsibilities

• Assist team members with queries and take ownership of their targets & goals
• Need to manage a team of 10-15 associates
• Adherences of the following norms
• Attendance
• Punctuality
• Reporting
• Completion of work